PMC5913035_01
A. Intracranial EEG from the frontal subdural grid showed seizure onset with low voltage fast activity in the electrode contacts 23.24. 27-32, 37, 38). B. MEG Spikes localized to the right inferior frontal region. C. Three-dimensional cortical models of the patient was generated using pre-operative structural magnetic resonance (MR) imaging and co-registered with the post-operative CT images using to identify electrode locations. Red dotes denote seizure onset with low voltage fast activity; blue dotes denote early propagation; yellow dotes denote late sporadic propagation. D. Functional language mapping results: red denotes naming pauses; orange denotes naming hesitancy; blue indicates face and tongue motor regions. E. Three-dimensional rendering of postoperative MRI, with arrow indicating the area of resection in the right inferior frontal area.
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However, video-EEG monitoring suggested that the seizure onset was in the right frontotemporal region, and magnetoencephalopgraphy (MEG) showed a cluster of spikes in the right inferior frontal and insular regions (Fig. 1B). The SOZ was identified in the inferior frontal area (Fig. 1A, C). The language tasks consisted of auditory responsive naming and Boston naming tasks. The functional mapping results showed that language responsive electrodes overlapped with the SOZ (Fig. 1D). A tailored cortical resection of SOZ in the right inferior frontal lobe (pars triangularis, BA 45) was performed, targeting the most active contacts in the seizure onset zone (Fig. 1E). following the operation, the patient was mute.