Abstract
We report a case of frontal lobe epilepsy that was characterized by manifested absence-like seizures which were likely to be of frontal origin. The patient was a 28-year-old right-handed man who had been treated with antiepileptic drugs following a generalized tonic-clonic seizure at the age of 14 months. This initial seizure was followed by atypical absence, which persisted until the age of 8 years. After about one year free of clinical seizures, he relapsed at the age of 9, exhibiting simple partial seizures in addition to absence-like seizures. Under simultaneous EEG-VTR monitoring, he exhibited seizures characterized by staring spells, arrest of speech, and alteration of consciousness. The concomitant EEG recordings showed diffuse 3Hz spike-waves with right frontal onset. His interictal EEGs showed isolated right frontal spikes. SPECT/PET findings supported a diagnosis of right frontal lobe epilepsy. At 7 years old, his EEGs showed diffuse irregular spike and wave complexes. Later, at the age of 8 years, these atypical spike and wave complexes disappeared, giving way to focal spikes. Finally, at the age of 10, he manifested diffuse 3Hz spike-wave discharges with frontal onset. These findings suggest that EEG abnormalities change with age in frontal absence.
