John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the

Ictal spitting in non-dominant temporal lobe epilepsy: an anatomo-electrophysiological correlation Volume 20, numéro 2, April 2018

Vidéos

  • Ictal spitting in non-dominant temporal lobe epilepsy: an anatomo-electrophysiological correlation
  • Ictal spitting in non-dominant temporal lobe epilepsy: an anatomo-electrophysiological correlation

Illustrations

  • Figure 1
  • Figure 2
  • Figure 3
Auteurs
1 Epilepsy Monitoring Unit, Department of Neurology, IMIM-Hospital del Mar, Barcelona
2 Centre for Genomic Regulation (CRG), Barcelona
3 Centre for Brain and Cognition, Universitat Pompeu Fabra (UPF), Barcelona, Spain
* Correspondence: Rodrigo Rocamora Epilepsy Monitoring Unit, Neurology Department, Hospital del Mar, Passeig Marítim 25-29, Barcelona 08003, Spain
  • Mots-clés : ictal spitting, prosopometamorphopsia, entorhinal cortex, SEEG, temporal lobe epilepsy, electrical stimulation, FCD-1a
  • DOI : 10.1684/epd.2018.0963
  • Page(s) : 139-45
  • Année de parution : 2018

We report a patient presenting drug-resistant, non-dominant temporal lobe epilepsy with ictal spitting and prosopometamorphopsia, both extremely rare semiologies. Second-phase pre-surgical monitoring was performed using SEEG due to lesion-negative imaging and the rare semiology. The seizure onset zone was delimited to the right anterior hippocampus and the temporobasal cortex, with the propagation zone within the entorhinal cortex. Interestingly, direct electrical stimulation to the entorhinal cortex, which was reproduced in a number of trials, evoked spitting without leading to seizures or post-discharges. After the resection of the epileptogenic zone, the patient remained seizure-free without AEDs for a follow-up period of five years (Engel Class 1a). The neuropathology revealed a focal cortical dysplasia type FCD-Ia. Spectral analysis of intracranial ictal EEG (iEEG) data suggested a possible role of the basal temporal and entorhinal cortex as a necessary node in ictal spitting. [Published with video sequences on www.epilepticdisorders.com].