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Ipsilateral head deviation related to orbito-frontal and fronto-polar seizures Volume 7, numéro 2, June 2005

Figure 1 A) MRI (FLAIR sequence) displaying a circumscribed, dysplastic lesion in the left fronto-polar cortex. B and C) 18F-FDG PET and [11C]flumazenil PET showing a focal abnormality at the site of the MRI lesion.

Figures 2 and 3 Lateral view of the patient’s brain showing the intracerebral electrodes (dots), the MRI lesion circumscribed by the dark grey line, and the borders of the surgical resection depicted by the white line.

Figure 4 SEEG recordings of the first seizure type showing a well localized ictal SEEG onset within the left fronto-polar region, which then spread to the left orbito-frontal region. IHD onset occurs concurrently with an intensification of the orbito-frontal ictal discharge (arrow).

Figure 5 SEEG recordings of the second seizure type showing an ictal onset which predominates over the orbito-frontal cortex, but also extends towards the fronto-polar and dorsolateral regions for a few seconds.Thereafter, the ictal discharge remains localized over the orbito-frontal cortex (arrow). IHD occurs during the first second of ictal onset, and continues while the SEEG discharge becomes restricted to the orbito-frontal region, until the end of the seizure.