PMC2673700_01
Axial T2 weighted image (A) and sagittal T1 weighted (B) images show the lesion (arrows), centered in the posterior cingulate gyrus. There was only mild patchy enhancement (not shown) and no significant edema or mass effect. Panel C shows a coronal T2 image with a depth contact proximal to the lesion, and panel D shows a sagittal T1 image with the location of another depth electrode. Not all depth contacts are visible because the trajectory of the depth arrays was not in the plane of the MR sections.
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F1
T1 weighted images and bright signal on T2 weighted images (Fig. 1) and no significant mass effect. The hippocampi were normal in appearance. Post-operative MRI confirmed excellent placement of the depth arrays with the deepest contact of the cingulate probe close to or within the cingulate lesion (Fig 1C, 1D).
Panel A illustrates one of ten seizures recorded with scalp arrays suggesting a right temporal lobe seizure onset. The ten seizures were similar clinically and electrographically. Scalp recordings were done prior to depth recordings.. Panel B illustrates one of the three seizure recorded with intracranial depth electrode arrays; the two ICEEGs are continuous. A prominent spike is seen from the cingulate region followed by low voltage fast activity better illustrated in the exploded view. Later prominent activity is recorded from the right hippocampal and amygdalar electrodes. No clinical signs or symptoms were seen or reported until the temporal lobe involvement with the seizures. All three seizures recorded with intracranial arrays were similar clinically and electrographically.
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F2
The ictal EEG (Fig 2A) was typically characterized by an initial buildup of rhythmic 2-5 Hz activity in the right temporal region that evolved to 8-9 Hz activity.