PMC5779748_01
(A-H) A brain MRI scan performed 5 days after the disease onset revealed patchy lesions in the left temporal lobe and hippocampus (A-D). The lesions exhibited low signal intensities on a T1-weighted imaging sequence (A) and high signal intensities on T2-weighted imaging (B), FLAIR (C), and DWI (D) sequences. Twenty-four days after the relapse, repeated brain MRI scans revealed new right temporal lobe and hippocampal lesions (E-H). The lesions exhibited low signal intensities on T1-weighted imaging (E) and high signal intensities on T2-weighted imaging (F), FLAIR (G), and DWI (H) sequences. DWI = diffusion-weighted imaging, FLAIR = fluid-attenuated inversion recovery, MRI = magnetic resonance imaging.
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F1
Brain magnetic resonance imaging (MRI) performed on admission revealed patchy lesions in his left temporal lobe and hippocampus (Fig. 1 A-D). Furthermore, MRI scans revealed new right temporal lobe and hippocampal lesions (Fig. 1E-H).
A 20- to 40-muV, 8-Hz background alpha rhythm was recorded in the left parietal and occipital lobes, where its amplitude was lower than that in the offside (A). During a seizure, low amplitude fast activity appeared in the left temporal region (B, marked with solid arrow) and gradually developed into medium-amplitude theta and delta activity (C, marked with solid arrow). Eventually, the voltage decreased and the background rhythm returned.
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F2
Video electroencephalography (EEG) (Fig. 2) recorded periodic epileptiform discharges and rhythmic jitter in his right arm.
The alpha rhythm was not obvious, and the theta wave was increased in the background (A). In the interictal discharge, sharp slow wave and slow wave activity appeared in the right frontal and right anterior temporal regions (B, marked with solid arrow). During seizure onset, medium-amplitude theta wave activity appeared in the right temporal region (C, marked with solid arrow). Its amplitude increased, and the right frontal region was affected (D, marked with solid arrow). The voltage eventually decreased, and background rhythms returned.
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F3
The video EEG examination revealed that his partial seizures originated from the right temporal lobe (Fig. 3).