PMC5811469_01
(A) Axial and (B) coronal 3 T MRI head scan shows blurry cortical gray and white matter on the left frontal lobe suggestive of focal cortical dysplasia (white arrow). Abbreviations: R, right; L, left.
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F1
A 28-year-old right-handed female presented to our service with neuroimaging findings compatible with frontal cortical dysplasia (Figure 1) refractory to AEDs.
(A) Sleep interictal scalp EEG shows epileptiform interictal discharges and focal slowing over the left fronto-central regions. Filters: 0.3-70 Hz. Notch: 60 Hz. Sensitivity: 7 microV/mm. (B) Ictal scalp video-EEG recording illustrates a clinical seizure onset over the left frontal central regions characterized by a fast and low voltage pattern with clonic right hemi-body seizures with Jacksonian march without loss of consciousness and preserved language. Filters: 1.0-35 Hz. Notch: 60 Hz. Sensitivity: 100 muVp-p.
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F2
A 10-h video-EEG recording showed 185 ictal (170 electrographic and 15 electro-clinical seizures) events of awake and sleep, mainly during sleep (10/15), characterized by brief focal clonic right hemi-facial seizures with or without Jacksonian march without loss of consciousness and preserved language, and with electrographic onset on the left fronto-central region; interictally showed 7-8 Hz background and 3-4 Hz focal slowing and epileptiform activity on the same region (Figure 2).