JLE

Epileptic Disorders

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RTTBD-like activity in association with hippocampal ictal discharges in patients with temporal lobe epilepsy Volume 22, issue 4, August 2020

Figure 1

RTTBD on scalp EEG recording. A sharply contoured RTTBD (5-6Hz) was present in the right temporal lobe on scalp EEG during Phase I pre-surgical video-EEG monitoring prior to the intracranial study. The RTTBD appeared sharply contoured or notched and maximal in the mid-temporal region at electrodes T10 and T8, but also involved the anterior temporal region at electrodes F10 and F8. It was more prominent over the subtemporal region at electrodes F10 and T10 than the lateral temporal region at electrodes F8 and T8. Filters: LF=2 Hz; HF=30 Hz.

Figure 2

RTTBD correlating with a hippocampal seizure. Simultaneous scalp (black) and hippocampal (pink) EEG recordings in a patient with left mesial TLE during sleep. The RTTBD (5-6 Hz) with flat-toped or notched appearance was present in the left temporal lobe on scalp EEG and correlated with the middle part of a left hippocampal seizure recorded on a single depth electrode placed along the longitudinal axis of the left hippocampus without lateral temporal bone defect. On scalp EEG, the RTTBD was more prominent over the subtemporal region at electrodes F9 and T9, compared to the lateral temporal region at electrodes F7 and T7. LHD: left hippocampus depth electrode. Filters: LF=2 Hz; HF=30 Hz.

Figure 3

RTTBD correlating with a hippocampal seizure with minimal ictal propagation; simultaneous scalp and hippocampal EEG recordings in a patient with right mesial TLE during wakefulness. The RTTBD (5-6 Hz) was present in the right temporal lobe on scalp EEG and correlated with the middle part of a right hippocampal seizure recorded on depth electrodes placed along the longitudinal axis of the right hippocampus and lateral temporal depth electrodes. On scalp EEG, the RTTBD was sharply contoured and notched. Upper panel: simultaneous recording with full sets of depth and scalp electrodes. Lower left panel: 3D-reconstructed depth electrodes. Lower right panel: correlation between the right temporal scalp RTTBD and right hippocampal ictal discharges is highlighted. RHD: right hippocampal depth electrode; RAT: right anterior temporal; RMT: right medial temporal; RPT: right posterior temporal. Filters: LF=2 Hz; HF=30 Hz.