JLE

Epileptic Disorders

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Selection criteria and preoperative investigation of patients with focal epilepsy who lack a localized structural lesion Volume 2, issue 4, Décembre 2000


   
   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.