42-year-old female with intractable seizures with seizure activity frequency of 1-2 brief seizures per day, felt to arise from the frontal lobe regions, but were nonlocalizing by video-EEG monitoring. (a) The MRI scan is normal. (b) The ictal Tc-99m HMPAO brain SPECT scan showed a focal area of significant hyperemia in the right mesial frontal lobe. (c) There was minimal reduction of F-18 FDG uptake in this location, but this was not specific for the identification of the epileptogenic focus.