Abstract
A Case of Hemimegalencephaly with Characteristic Evolvement of EEG Ritsuko Shigetomo, Hiroyuki Shimizu, Taketoshi Maehara, Nobuyoshi Kaito, Akira Yagishita, Masaya Oda, Nobutaka Arai, Kazuhiko Komiya, Hiroshi Tanaka, Fumio Hayakawa We report a case of hemimegalencephaly whose serial EEGs disclosed very interesting features.The patient's seizures started immediately after birth. Scalp EEG first showed epileptic discharges in the right affected brain. However, over the time course of three years with intransigent seizures, interictal epileptic discharges gradu-ally shifted from the right hemisphere to the contralateral“healthy”brain. At the age of 3 years and 4 months, she underwent a right functional hemispherectomy. After the operation, her seizures completely ceased, with the exception of slight myoclonic jerks in the morning.We speculate that a mirror focus may have been formed in the opposite hemisphere by incessant electric stimulation from the affected hemisphere. This case undescores the importance of a comprehensive diagnosis which encompasses scalp EEG, semiology, and image diagnosis for the selection criteria of epilepsy surgery.
