title: Surgically proven coexistence of focal and generalized epilepsy: a case report.
abstract: The coexistence of focal and idiopathic generalized epilepsy (IGE) is rarely observed, and the mechanism underlying this situation remains unknown. We report a 13-year-old girl with well-controlled generalized epilepsy and medically-refractory left temporal lobe epilepsy. She underwent intracranial EEG recording, which demonstrated two characteristic seizure patterns of generalized ictal onset and left mesial temporal onset. In addition, two types of interictal spike distribution, including the left mesial temporal region and generalized spikes, were also supportive of the coexistence of left mesial temporal lobe epilepsy and IGE. Thereafter, a left anterior temporal lobectomy and post-surgical medication significantly improved her seizure outcome. This case illustrates the importance of considering surgical management for patients with medically-intractable focal epilepsy coexisting with generalized epilepsy.
authors.affiliation: Epilepsy Center, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. enatsur@ccf.org
authors.forename: Rei
authors.initials: R
authors.lastname: Enatsu
authors.forename: Elaine
authors.initials: E
authors.lastname: Wyllie
authors.forename: Prakash
authors.initials: P
authors.lastname: Kotagal
authors.forename: William
authors.initials: W
authors.lastname: Bingaman
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D001931:Brain Mapping; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D004829:Epilepsy, Generalized / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography