An 82-year-old woman with a history of chronic left parietal ischemic infarction presented with acutely altered mental status and abnormal right-sided movements. MRI (figure 1) demonstrated gyriform reduced diffusion signal, T2 hyperintensity, and swelling in the left cerebral hemisphere and contralateral right cerebellum. EEG (figure 2) revealed lateralized periodic discharges, likely represen...

CONTEXT Anterior temporal lobectomy is an effective treatment for medically intractable temporal lobe seizures. Identification of seizure focus is essential to surgical success. OBJECTIVE To examine the usefulness of presurgical electroencephalography (EEG), magnetic resonance imaging (MRI), and neuropsychological data in the lateralization of seizure focus. DESIGN Presurgical EEG, MRI, and...

The brain is lateralized morphologically and functionally, with unique species-related specifications [...]

OBJECTIVE Corpus callosotomy tends to decrease seizure frequency and severity rather than transforming the seizure pattern from a generalized form into a lateralized or a partial one. The finding implies that bisection of the corpus callosum (CC) disrupts the epileptogenicity itself. In order to gain further insight into the possible role played by the CC in intractable generalized epilepsy, qu...

Abstract Background Available data from witnessed and monitored sudden unexpected death in epilepsy (SUDEP) cases postulate that ictal central apnea (ICA) arrhythmias are the main causes of SUDEP. ICA is a frequent semiological feature focal occasionally only clinical manifestation seizures. The aim this study was to assess frequency cardiac epileptic patients risk factors predictors their occu...

BACKGROUND To evaluate the use of unbiased computer-assisted lateralization of temporal lobe epilepsy (TLE) by z-score parametric PET imaging (ZPET). METHODS 38 patients with histologically proven unilateral TLE due to pure hippocampal sclerosis, referred for pre-surgical PET evaluation of intractable seizure over a 5-year period, were included. The F-18 FDG images were oriented along tempora...

Commentary Hemispherectomy was introduced by Walter Dandy in 1928 for removal of a right hemispheric glioma (1) but was pioneered for use in catastrophic epilepsy by McKenzie a decade later (2). The procedure was abandoned for years due to its morbidity and mortality but was repopularized in 1950 by Krynauw, who used it to treat infantile hemiplegia (3). The techniques of hemispherectomy then u...

PURPOSE To identify the probability of detecting nonconvulsive seizures based on the initial pattern seen in the first 30 minutes of continuous EEG (cEEG) monitoring. METHODS Continuous EEG monitoring reports from 243 adult patients were reviewed, assessing the baseline cEEG monitoring pattern and the presence of seizures during the entire monitoring period. The baseline EEG patterns were cla...

PURPOSE We compared the metabolic information obtained from single-voxel proton MR spectroscopy and positron emission tomography (PET) in patients with temporal lobe epilepsy. METHODS Twenty-nine patients with temporal lobe epilepsy were screened for metabolic abnormalities with both proton MR spectroscopy and PET. Lateralization with MR spectroscopy was possible by using NAA/(Cho+Cr) and an ...

PURPOSE Emergent EEG (eEEG) is an EEG performed on a non-elective basis upon request from a clinician for a seemingly emergency indication. Little is known about the long-term prognosis of patients with emergent periodic lateralized epileptiform discharges (ePLEDs). METHODS We analyzed the EEG and clinical records of patients with ePLEDs from January 2002 to December 2008. RESULTS Out of 19...