Indian J Med Microbiol Close
 

Figure 2: A 24-year-old left-handed man with refractory extratemporal seizures (case 1-Table 1). (a) Multiple scalp lacerations resulting from epileptic falls. (b and c) MRI brain (T1) showing left parietal porencephalic cyst. (d) Functional MRI demonstrates language lateralization to right hemisphere. During VEEG, interictal epileptiform discharges were noted from left posterior head region, left temporal, and right temporal regions (arrows) (e, f, and g). Multiple habitual seizures were captured without clear lateralization with early head deviation to the left. Ictal EEG showed subtle alphoid rhythm over the right frontal temporal regions (h). Invasive monitoring with coverage of bilateral frontal lobes, left temporal and left parietal occipital regions with multiple subdural lines documented typical habitual seizures to start from left parieto-occipital region with low amplitude fast rhythm and spreading rapidly to the frontal regions causing early head deviation to left side and fi nally ictal rhythm dominantly evolved over the left temporal region (i). Intraoperatively, the gliosis extended from the parietal region to the temporal lobe. Very frequent temporal spikes were seen on corticography. Left Posterior quadrant disconnection done with grade I outcome

Figure 2: A 24-year-old left-handed man with refractory extratemporal seizures (case 1-Table 1). (a) Multiple scalp lacerations resulting from epileptic falls. (b and c) MRI brain (T1) showing left parietal porencephalic cyst. (d) Functional MRI demonstrates language lateralization to right hemisphere. During VEEG, interictal epileptiform discharges were noted from left posterior head region, left temporal, and right temporal regions (arrows) (e, f, and g). Multiple habitual seizures were captured without clear lateralization with early head deviation to the left. Ictal EEG showed subtle alphoid rhythm over the right frontal temporal regions (h). Invasive monitoring with coverage of bilateral frontal lobes, left temporal and left parietal occipital regions with multiple subdural lines documented typical habitual seizures to start from left parieto-occipital region with low amplitude fast rhythm and spreading rapidly to the frontal regions causing early head deviation to left side and fi nally ictal rhythm dominantly evolved over the left temporal region (i). Intraoperatively, the gliosis extended from the parietal region to the temporal lobe. Very frequent temporal spikes were seen on corticography. Left Posterior quadrant disconnection done with grade I outcome