title: Complete change of seizure and spike lateralization in temporal lobe epilepsy at two separate monitorings.
abstract: OBJECTIVE
  To report complete change of seizure and spike lateralization over time in bilateral temporal lobe epilepsies (TLE).
  
  
  METHODS
  Repetition of video-EEG monitorings in 115 patients; 2 cases are reported in detail; 113 other severe partial epilepsies were included to estimate retrospectively the frequency of the reported phenomenon.
  
  
  RESULTS
  In 2 cases, two video-EEG monitorings, separated by several months, revealed the first time one unilateral TL (temporal lobe) seizure and spike focus and the second time a distinct seizure and spike focus located in the opposite TL. The second monitoring was planned for these two patients because of the presence of a discordant lesion or, in the absence of a lesion, of some bilateral or discordant functional (EEG, SPECT and PET) abnormalities. No patient among the other 113 cases had this video-EEG pattern.
  
  
  CONCLUSIONS
  In TLE, two video-EEG sessions may be necessary to disclose two opposite TL epileptogenic foci.
  
  
  CONCLUSIONS
  In rare bilateral TLE cases, the expression of seizure and spike foci can alternate between hemispheres.
authors.affiliation: AP-HP, Epileptology Unit, Hôpital de La Pitié-Salpêtrière, Service de Neurologie 1, Hôpital de La Pitié-Salpêtrière 47-83 Bd de 1'Hôpital 75651, Paris Cedex 13, France.
authors.forename: Areti
authors.initials: A
authors.lastname: Koukou
authors.forename: Sophie
authors.initials: S
authors.lastname: Dupont
authors.forename: William
authors.initials: W
authors.lastname: Szurhaj
authors.forename: Michel
authors.initials: M
authors.lastname: Baulac
authors.forename: Philippe
authors.initials: P
authors.lastname: Derambure
authors.forename: Claude
authors.initials: C
authors.lastname: Adam
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D003884:Dermoid Cyst / Q000150:complications / Q000473:pathology; D004569:Electroencephalography / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005071:Evoked Potentials; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D014743:Videotape Recording