Contradictory imaging and EEG results in resection surgery of bitemporal lobe epilepsy: A case report

Yang,Kang; Su,Jing; Lang,Yue; Liu,Shu‑Ping; Yin,Jian

doi:10.3892/etm.2013.1462

Contradictory imaging and EEG results in resection surgery of bitemporal lobe epilepsy: A case report

Authors:
- Kang Yang
- Jing Su
- Yue Lang
- Shu‑Ping Liu
- Jian Yin
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Affiliations: Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China, Epileptic Center of Liaoning, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116044, P.R. China
Published online on: December 27, 2013 https://doi.org/10.3892/etm.2013.1462
Pages: 731-733

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Abstract

The present study describes the case of a 27‑year‑old, right‑handed female with bilateral mesial temporal lobe epilepsy. Electroencephalogram (EEG) monitoring from implanted electrodes displayed two different and independent onsets on the two sides of the mesial temporal structures, which specifically included clinical generalized tonic clonic seizure (GTCS) discharges originating from the left mesial temporal lobe, as well as complex partial seizure (CPS) discharges arising from the right mesial region. However, fluid‑attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) showed a unilateral abnormality, as in right mesial temporal lobe sclerosis. A decision was made to resect one side of the mesial temporal lobe, in order to avoid memory function impairment, and, relying on the MRI results, the right side was selected. However, surgery did not leave the patient seizure‑free. The CPSs gradually eased, while the GTCSs originating from the left side became severely aggravated. In describing this case, the drawbacks of current epileptic diagnostic methods and surgical strategies for bitemporal lobe epilepsy are discussed, and the requirement for more treatment options is emphasized.

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