Abstract
We reported a case of frontal lobe epilepsy which was considered to have evolved from Lennox-Gastautsyndrome (LGS). The patient was a 17-year-old male with severe mental retardation, and had suffered from LGS since the age of 7. Clinical seizures consisted of tonic seizure, head nodding and atypical absence. EEG showed 2.5 c/s diffuse slow spike wave complexes as well as rapid spikes during sleep However, clinical seizures disappeared at the age of 12 and at that time no more epileptiform activity could be seen on EEG. Seizure had been controlled completely for three years until it relapsed with impaired consciousness, stereotyped automatism and violent body movement. They occurred rather frequently but postictal confusion-al state was brief or almost absent. EEG showed ictal discharges starting from both frontal regions simultaneously and there were sporadic interictal spikes over the left frontal region. Any evidence of LGS could not be seen clinically or electrically. Taking these findings into consideration, seizures are most probably of frontal origin and we conclude that the patient now has frontal lobe epilepsy rather than LGS.
It is very rare for LGS to evolve into frontal lobe epilepsy and we suspect that secondary epileptogenesis is most probably the cause of this evolution.
