[An operated case of intractable occipital lobe epilepsy associated with calcification in the occipital lobe].
We reported a 20-year-old female of intractable occipital lobe epilepsy associated with calcification in the left occipital lobe. She developed seizures since 2 years old and electroencephalography showed paroxysmal activities on the left occipital area. At 8 years old, partial resection of the lesion and interictal spike focus under intraoperative corticography guidance was performed, but the favorable seizure outcome was not obtained. At the age of 20 years old, the frequency of her seizures has increased and admitted to our department. Preoperative evaluation with chronic invasive subdural recording showed that the ictal zone was located in the inferior (tentorial) surface and convexity of the left occipital lobe. Functional mapping involving cortical stimulation and cortical recording of pattern-reversal visual evoked potentials demonstrated that the ictal onset zone was not in the visual area. Following cortical resection of the ictal onset zone and multiple subpial transection on the surrounding cortex, she had good relief with less than one minor seizure per 1-3 months. Histological findings of the resected specimen were consistent with those of Sturge-Weber syndrome. Thus chronic invasive subdural recording may improve seizure outcome in patients whose epileptogenic area was located near the visual field.
Ohara
S
S
Department of Neurosurgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Morioka
T
T
Nishio
S
S
Ishibashi
H
H
Fukushima
T
T
Mitsudome
A
A
Fukui
M
M
D000328:Adult; D001927:Brain Diseases / Q000150:complications*; D001931:Brain Mapping; D002114:Calcinosis / Q000150:complications*; D004562:Electrocardiography; D004827:Epilepsy / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D009778:Occipital Lobe / Q000503:physiopathology*; D013341:Sturge-Weber Syndrome / Q000150:complications