Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Epidural electrodes could safely delineate ictal focus of hyperkinetic seizure in intractable frontal lobe epilepsy

Mayumi Otani, M.D.1), Masao Matsuhashi, M.D., Ph.D.2), Akio Ikeda, M.D., Ph.D.2), Susumu Miyamoto, M.D. Ph.D.3) and Ryosuke Takahashi, M.D., Ph.D.1)

1) Department of Neurology, Kyoto University Graduate School of Medicine
2) Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine
3) Department of Neurosurgery, Kyoto University Graduate School of Medicine

A 42-year-old male had intractable hyperkinetic seizure since childhood. Bottom-of-sulcus dysplasia was shown by MRI to be most likely an ictal focus, whereas ictal semiology suggested possible focus in the left frontal cortex. Scalprecorded EEG could not delineate ictal EEG change at all partly because of violent hyperkinetic seizure, and thus intracranial EEG study by epidural electrodes was conducted as the best procedure for the safety concern. It showed ictal focus over the bottom-of-sulcus dysplasia and thus it was completely resected with seizure free more then 20 years until now. It was concluded that epidural electrodes are regarded as safe invasive recording method especially for violent hyperkinetic seizure, and that can provide us with essential information before epilepsy surgery.
Full Text of this Article in Japanese PDF (2504K)

(CLINICA NEUROL, 62: 130−134, 2022)
key words: epidural electrode, frontal lobe epilepsy, hyperkinetic seizure, bottom-of-sulcus dysplasia (BOSD)

(Received: 27-Apr-21)