PMC5913040_01
Interictal EEG (A) and ictal EEG (B). A: Interictal discharge was seen at F7, T1 but could not always be replicated. (Time Constant, 0.3 s; High cut filter, 50 Hz; Average). B: Ictal evolution with maximal voltage at F7, T1. (Time Constant, 0.1 s; High cut filter, 50 Hz; Average).
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Interictal EEG showed only low-voltage spikes at F7 and T1, which were not consistently replicated in subsequent recordings (Fig. 1A). During the "provoking" session (Fig. 1B), the patient heard: "You mean your seizures seem to happen just after you talk about your mother-in-law or think about the car accident, right? That's quite unbelievable." or "If you avoid stressors, your seizures should become manageable." After weakly replying, "Yes, yes..." she exhibited a seizure.
FDG-PET (coronal section). Decreased glucose metabolism in left mesial temporal lobe including anterior entorhinal cortex (arrows). Rt, right; Lt, left.
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MRI. A: T2 weighted axial section. Slight enlargement and high intensity of the left amygdala (arrow) are detected. Due to a methodological limitation, volumetry is not performed.. B: T2 weighted, axial section. Loss of gray-white matter differentiation of the left temporal tip (circle) is detected.. C: Fluid-attenuated inversion recovery, coronal section. Three-layered structure is damaged in the left hippocampus (arrow). Neither cortical dysplasia nor tumor is detected. Rt, right; Lt, left.
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AE and signal elevation (Fig. 3A) with slight changes in the left temporal tip (loss of gray-white matter differentiation, Fig. 3B) and in the left hippocampus (damaged three-layered structure, Fig. 3C). Additionally, the MEG was consistent with the diagnosis.