PMC6370593_01
(a, b) Interictal electroencephalography (EEG) demonstrates paroxysmal activity (a, black arrow) and temporal intermittent rhythmic delta activity (TIRDA) (b, black arrow) over the right temporal region (F8 and T4 on the international 10-20 system of electrode placement). (c) Ictal EEG indicates that ictal discharge began in right anterior temporal region (F8, black arrow). (d) T1-weighted magnetic resonance images (T1WI; tilted axial view oriented along the long axis of the hippocampus) demonstrated an enhancing tumor with gadolinium (Gd) contrast (white arrow). On tilted axial (e) and (f) coronal views of fluid-level attenuated-inversion recovery (FLAIR) images, no atrophy or hyperintensity of the ipsilateral hippocampus was noted. (g) 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) at sections comparable to (d) and (e) shows hypometabolism in the right medial temporal region as well as the lateral region.
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Continuous ictal discharges were recorded from the electrodes on the hippocampus, 1.5-2.5 cm from the hippocampal head (Fig. 2f, upper 5 traces).