Premium
SEEG re‐exploration in a patient with complex frontal epilepsy with rapid perisylvian propagation and mixed “startle ‐ reflex” seizures
Author(s) -
Maliia Mihai Dragos,
Kahane Philippe,
Nica Anca,
Mindruta Ioana,
Castana Laura,
Cardinale Francesco,
Francione Stefano
Publication year - 2021
Publication title -
epileptic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 53
eISSN - 1950-6945
pISSN - 1294-9361
DOI - 10.1684/epd.2021.1246
Subject(s) - stereoelectroencephalography , moro reflex , psychology , epilepsy , neuroscience , reflex , epilepsy surgery , anesthesia , audiology , medicine
The SEEG International Course, organised in 2017, focused on the investigation and surgery of insulo‐perisylvian epilepsies. We present one representative complex case that was discussed. The patient had seizures displaying startle/reflex components. He was MRI negative, while other non‐invasive investigations offered only partially concordant data. Initial SEEG exploration resulted in an incomplete definition of the epileptogenic zone. A second SEEG followed, which led to a thorough assessment of the seizure onset zone and the epileptic network, localised to the lateral inferior premotor cortex, explaining the incongruent data obtained beforehand. This was the basis of a tailored resection with a favourable outcome. The patient has been seizure‐free for five years without any motor nor cognitive deficits, but with pharmacodependence to one AED. The electroclinical reasoning is presented, accompanied by relevant commentaries and recommendations from the tutors [ Published with video sequences ].