Stereotactic cortical resection in non-lesional extra-temporal partial epilepsy

D. C. Shields, D. J. Costello, J. T. Gale, D. B. Hoch, E. N. Eskandar

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

The presentation and treatment of a patient with extra-temporal non-lesional partial epilepsy is discussed herein. His clinical semiology was consistent with supplementary motor area seizures; however, MR imaging did not demonstrate a lesion. A region of stable cortical glucose hypermetabolism in the left frontal region was noted with 2-fluoro-2-deoxy-D-glucose (FDG)-PET. This was consistent with the frequent interictal discharges evident over the left fronto-temporal region and the stereotypic high amplitude ictal discharges arising with highest amplitude from the left frontal region. Epileptiform activity evident on an intracranial 64-point subdural recording grid placed over the left dorsolateral frontal cortex confirmed a distribution concordant with FDG-PET findings. The subsequent resection was guided by the PET and EEG findings rather than structural MR imaging, and a limited cortical resection led to an immediate and substantial reduction in seizure frequency.

Original languageEnglish (US)
Pages (from-to)1186-1188
Number of pages3
JournalEuropean Journal of Neurology
Volume14
Issue number10
DOIs
StatePublished - Oct 1 2007
Externally publishedYes

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Keywords

  • Epilepsy surgery
  • Epileptogenic zone
  • Extra-temporal epilepsy
  • Non-lesional epilepsy
  • Partial seizure

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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