SEEG re-exploration in a patient with complex frontal epilepsy with rapid perisylvian propagation and mixed “startle - reflex” seizures
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2023
- handle: 10670/1.ytoxnt
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epilepsy surgery insular-opercular epilepsy premotor epilepsy startle seizures reflex seizures focal cortical dysplasia SEEGSujets proches
Searches and seizures--Law and legislation SeizuresCiter ce document
Mihai Dragos Maliia et al., « SEEG re-exploration in a patient with complex frontal epilepsy with rapid perisylvian propagation and mixed “startle - reflex” seizures », Epileptic Disorders, ID : 10670/1.ytoxnt
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The SEEG International Course, organised in 2017, focused on the investigation and surgery of insulo-perisylvian epilepsies. We present one representative complex case that was discussed. The patient had seizures displaying startle/reflex components. He was MRI negative, while other non-invasive investigations offered only partially concordant data. Initial SEEG exploration resulted in an incomplete definition of the epileptogenic zone. A second SEEG followed, which led to a thorough assessment of the seizure onset zone and the epileptic network, localised to the lateral inferior premotor cortex, explaining the incongruent data obtained beforehand. This was the basis of a tailored resection with a favourable outcome. The patient has been seizure-free for five years without any motor nor cognitive deficits, but with pharmacodependence to one AED. The electroclinical reasoning is presented, accompanied by relevant commentaries and recommendations from the tutors [Published with video sequences].