PMC9092987_01
a. Interictal right temporal polymorphic delta slowing. b. MRI brain revealed no abnormalities. c. Interictal PET depicting right mesial temporal hypometabolism. d. Implanted SEEG electrodes: HH: Hippocampal head, HB: Hippocampal body, STG: Superior temporal gyrus, OF: Orbitofrontal lobe, AI: Anterior insula, PI: Posterior insula, TPO: Temperoparietooccipital Junction, PC: Precuneus.
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Interictal EEG showed right temporal polymorphic delta slowing (Fig. 1a.). He underwent imaging with a 3.0T MRI scanner under an epilepsy protocol, which was normal (Fig. 1b.). No abnormal areas of hypometabolism were detected in the insula or lateral temporal region (Fig. 1c.). SEEG implantation and extra-operative monitoring was discussed. 8 SEEG electrodes (Ad-Tech, 10 contact with 7 mm spacing) were implanted in the right hippocampus (HC) (head and body), posterior superior temporal gyrus (STG) (covering the Heschl's gyrus), temporo-parieto-occipital junction (TPO), precuneus, orbitofrontal region and the anterior and posterior insula (Fig. 1d.).
a. Interictal abnormalities in the head and body of the hippocampus and anterior insula. b. Ictal SEEG of habitual event: onset from the head of the right HC.
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Interictal abnormalities were seen predominantly in the head and body of the hippocampus and anterior insula (Fig. 2a.). Six habitual events were recorded which began in the head of the right HC (Fig. 2b.).
PMC9092987_02
PMC9092987_03