JLE

Epileptic Disorders

MENU

Epilepsia partialis continua triggered by traumatic hand injury: a peripheral tuning of brain excitability? Volume 18, issue 1, March 2016

Figure 1

(A) MRI T2-weighted coronal image before the first surgery with right hippocampal hyperintensity convergent with interictal and ictal scalp EEG. Note the enlarged right lateral ventricle and prominence of right hemisphere sulci. (B) MRI T2-weighted axial image 10 years later, when EPC began. Note persistent right hemisphere atrophy, particularly of the parietal cortex (arrow). (C) Axial functional MRI during EPC demonstrating bilateral primary sensory cortex activation. (D) Electrocorticography with continuous spike-wave activity over the right motor (arrow A) and sensory areas (arrow B), predominating on the depth of central sulcus (white circle). (E) Sagittal T1-weighted image post-resection of the depth of central sulcus (arrow). (F, G) Photomicrographs of H&E and NeuN staining, respectively, showing abnormal radial lamination and neuronal distribution in micro-columns at 50x magnification.

Figure 2

(A) Pre-resection scalp EEG at EPC presentation, with remaining interictal right temporal discharges. Note that rolandic regions are electrically silent. (B-D) Sequential sections of scalp EEG after rolandic resection and full control of the EPC. Electrographic seizures are seen in the right temporal lobe, without clinical symptoms. This abnormality was not present before resection.