PMC6215994_01
Interictal EEG; Right temporal sharp-and-wave discharge during stage 2 sleep. AP bipolar montage, TC 0.3, HFF 70 Hz, Sen 7 uV.
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Her noninvasive diagnostic studies, including inpatient video-EEG monitoring, brain MRI, FDG-PET, and neuropsychology testing, were concordant and implicated an epileptogenic zone within the right temporal lobe (Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5).
A-B - Preoperative brain MRI (coronal FLAIR sequence); there is atrophy, loss of internal architecture, and increased FLAIR signal within the right mesial temporal structures and hippocampus.
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Her noninvasive diagnostic studies, including inpatient video-EEG monitoring, brain MRI, FDG-PET, and neuropsychology testing, were concordant and implicated an epileptogenic zone within the right temporal lobe (Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5).
A-C - Post-operative brain MRI (A - coronal magnetization-prepared rapid gradient-echo (MP-RAGE), B - axial MP-RAGE, C - sagittal MP-RAGE); there are post-surgical changes in the right temporal lobe without obvious structural abnormalities within the adjacent right frontal and temporal lobes.
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In light of these findings, a right standard ATL was completed (Fig. 4). A repeat brain MRI demonstrated postsurgical changes in the right anterior temporal lobe with adjacent increased T2/FLAIR signal along the superior and posterior resection cavity (Fig. 4A-C).
Post-operative ictal EEG; Right fronto-central seizures, 15 seconds after EEG and clinical onset. AP bipolar montage, TC 0.1, HFF 70 Hz, Sen 7 uV.
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Her noninvasive diagnostic studies, including inpatient video-EEG monitoring, brain MRI, FDG-PET, and neuropsychology testing, were concordant and implicated an epileptogenic zone within the right temporal lobe (Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5). Continuous video-EEG monitoring revealed focal motor status epilepticus with seizures arising from the right fronto-central region (Fig. 5, Fig. 6).