Abstract
We presented a patient with frontal lobe epilepsy who had a circumscribed cortical lesion in the left medial frontal lobe and confirmed epileptogenic zone in its vicinity by magneto-encephalographic (MEG) findings.
The patient was a 17-year-old girl who had suffered from frequent epileptic tonic extension of extremities following bilateral peri-oral contractions since the age of 1 year and 2months. Her seizures occurred almost daily at the examination. On the interictal scalp EEG frequent spikes were seen dominantly on Fz and Cz, though spike and spike with slow wave seemed bilateral and synchronous. On ictal scalp EEG the increased interictal spikes just before seizure were suppressed at the seizure onset and after then bilateral diffuse spike rhythm was followed. We could not define the exact epileptogenic focus on EEG. However the calculated equivalent current dipoles (ECDs) of interictal spikes and the ictal spikes at the seizure onset on MEG were densely clustered near the circumscribed lesion which was found in the left medial frontal lobe on MRI. Consequently, we thought that there was epileptogenic zone in the vicinity of lesion. MEG findings may be helpful to find the epileptogenic focus in the medial side of brain, though it will have to wait for further study.
