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28.03.2010
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A 26 year-old female with intractable partial seizures. with no lateralizing features. Scalp VEEG showed interictal spikes broadly distributed over the right posterior-temporal region. Seizure activity was non-localizing

Crytogenic Lateral Temporal Lobe Epilepsy

CASE STUDY: Cryptogenic Lateral Temporal Lobe Epilepsy 

Physician: Robert Knowlton, M.D., 
University of Alabama, Birmingham. 

Case study: 
A 26 year-old female with intractable partial seizures. with no lateralizing features. 
Scalp VEEG showed interictal spikes broadly distributed over the right posterior-temporal region. Seizure activity was non-localizing. 

MRI was normal. 

FDG-PET showed a questionable focal relative hypometabolism in the right posterior temporal area. 
An MEG study was conducted using a 4-D Neuroimaging Magnes II 74-channel sensor configuration. MEG spike localizations showed a focal cluster in the right posterior temporal area corresponding exactly to the possible PET abnormality. 
The agreement between the MEG and FDG-PET data, which were consistent with the scalp EEG, was sufficient to send the patient to surgery. 

A cortical resection with ECoG was performed. The pathology showed a neuronal dysgenesis. 
The patient had no residual deficits and was seizure-free after surgery.  
Conclusion: 
The combination of non-invasive MEG and scalp EEG, with minimally-invasive FDG-PET was sufficient to define a surgical plan that rendered the patient seizure free, even though the MRI was non-diagnostic.