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 Printable version |
Clinical impact of a high-frequency seizure onset zone in a case of bitemporal epilepsy |
Epileptic Disorders. Volume 10, Number 3, 231-8, September 2008, Clinical commentary with video sequences
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 Free Article
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Author(s) : Premysl Jiruska, Martin Tomasek, David Netuka, Jakub Otahal, John GR Jefferys, Xiaoli Li, Petr Marusic |
Summary : High-frequency activity has been described as having a role in the initiation of epileptic seizures. The case of a patient with refractory bitemporal epilepsy is presented. Extraoperative monitoring with depth and subdural electrodes revealed an ictal pattern with a build-up of high-frequency (> 80 Hz) activity originating in the cortex, with spread to both hippocampi. This observation was only revealed with the use of high-pass filtering, and represented crucial information that significantly influenced the decision about the side, localization and extent of resection. Removal of the cortex generating high-frequency activity, led to cessation of seizures in this patient. Current knowledge about the role of high-frequency activity and the case presented here support the importance of recording with equipment capable of detecting fast activity during the presurgical invasive monitoring. An active search for a high-frequency seizure onset zone in patients with structurally-unaffected hippocampi may improve the outcome beyond that possible with conventional bandwidth, invasive EEG recordings. [Published with video sequences] |
Keywords : bitemporal epilepsy, ictal high-frequency activity, seizure onset zone, ictogenesis |
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