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Figure 1a. Neuroimaging
data in a patient with "non-lesional epilepsy". Ictal SPECT showing focal
regions of hyperperfusion over the left posterior frontal convexity and
non-homologous right anterior frontal convexity. The MRI scan had been interpreted
as normal on blinded review. Retrospective examination however suggested
a thickened infolded gyrus in the region corresponding to the left frontal
hyperperfused region on the Ictal SPECT scan. b. Ictal Subdural EEG
recording in the same patient revealed focal onset over the left frontal
lobe (top arrow) with propagation to the right frontal lobe ten seconds
later (bottom arrow). The patient is seizure-free following a left frontal
corticectomy. |