Figure 4
(A-C) SEEG traces. (A) Stereo-EEG showing seizure onset with slow waves in the right mesial orbitofrontal region (seen immediately after montage labeling), followed by diffuse attenuation with overlying gamma activity over the anterior prefrontal region (blue arrows) and then rhythmic alpha activity (red arrows). (B) Seizure evolution with rhythmic alpha activity over the right anterior prefrontal region, with highest amplitude over the right mesial orbitofrontal to lateral frontal area and lower amplitude over the right anterior cingulate area, that evolves to rhythmic beta activity (red arrow), corresponding clinically to a counterclockwise head roll. To a lesser extent, there is rhythmic alpha seen over the left mesial orbitofrontal to lateral frontal region (green arrow). (C) Continuation of the right anterior prefrontal seizure (red arrow) with new-onset independent rapid beta spiking in the L amygdala/ hippocampal region (yellow arrow). L: left; R: right; mOlF: mesial orbitofrontal to lateral frontal; aCaS: anterior cingulate to anterior superior frontal gyrus; AgpT: amygdala to posterior temporal; AglT: amygdala to lateral temporal.