A 16-year-old girl with focal seizures and impaired awareness: divergent non-invasive data related to a diffuse epileptogenic network.
We describe a patient with medically refractory focal epilepsy who presented with divergent non-invasive data, with MRI revealing hippocampal sclerosis and EEG indicating involvement of the occipital lobe. A localized corticectomy over the occipital convexity was performed based on intracranial EEG recording. The patient was seizure-free after four years of follow-up. Electroclinical hypotheses and challenges of defining the epileptogenic network are discussed.
IRCCS, Institute of Neurological Sciences of Bologna, Child Neurology Unit, Bologna, Italy.
Angelo
A
Russo
Department of Neurology and Comprehensive Epilepsy Program, Brain Institute, Nicklaus Children's Hospital, Miami, Florida.
Prasanna
P
Jayakar
Department of Neurology and Comprehensive Epilepsy Program, Brain Institute, Nicklaus Children's Hospital, Miami, Florida.
Ian
I
Miller
Departments of Neurological Surgery, Nicklaus Children's Hospital, Miami, Florida, Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Sanjiv
S
Bhatia
Department of Neurology and Comprehensive Epilepsy Program, Brain Institute, Nicklaus Children's Hospital, Miami, Florida, Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Michael
M
Duchowny
D000293:Adolescent; D001364:Awareness / Q000502:physiology*; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009415:Nerve Net / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019635:Neurosurgical Procedures; D012640:Seizures / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome
atypical epileptogenic network; epilepsy surgery; hippocampal sclerosis; intractable epilepsy; occipital resection