PMC5067064_01
(A) MRI examination showing a left parietal-occipital encephalomalacia focal signal alteration in the patient's brain (arrow): sagittal T1 MRI (i); axial T1 MRI (ii); axial T2-weighted MRI (iii). (B) MRI image of the patient's brain after left parietal-occipital lesion-resection surgery, showing that doubtful epileptic foci were completely removed: axial T1 MRI (i); sagittal T1 MRI (ii); three-dimensional MRI showing the resected cortex surface (iii).. Abbreviations: MRI, magnetic resonance imaging; R, right; L, left.
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Serial brain MRI examinations revealed a left parietal-occipital brain-region encephalomalacia focal signal alteration (Figure 1A). Following evaluation of epilepsy symptoms, focal seizures, and a combination of MRI and EEG images, a left parietal-occipital lesion resection was performed on the patient (Figure 1B), with the neuropathology confirming the left parietal-occipital lesion was an encephalomalacia focus.
The vagus nerve-stimulation device used for implantation, obtained from PINS Medical (Beijing, People's Republic of China; http://www.pinsmedical.com/).. Notes: (A) The handheld device is used for programming and to setup the stimulation parameters. (B) The communication-link device enables communication between the external handheld device and the internal implantable pulse generator. (C) The implantable pulse generator, accessory extension cord, and the leads which are fixed in the vagus nerve.
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A VNS device (PINS Medical, Figure 2) was subsequently implanted 1 year after the surgical resection.