Review Article

Neocortical Temporal Lobe Epilepsy

Figure 1

EEG of a 37-year-old right-handed male with complex partial seizures since 16 years of age characterized by speech arrest, transient impaired consciousness, automatisms with right hand, and secondary generalization, with no contributory antecedent history.
(a) Interictal scalp showing right anterior temporal spikes during sleep
(b) Ictal scalp EEG in the same patient showing possible bitemporal onset of seizure
(c) Sagital T2 FLAIR MRI brain showing left posterior temporal neoplasm (pathologically proven ganglioglioma)
(d) Interictal subdural EEG showing spikes arising independently from left mesial and neocortical temporal lobe (electrodes 10s, 30s, and 50s) as well as right anterior mesial and neocortical regions (electrodes 20s and 40s)
(e) Ictal subdural EEG showing seizure onsetting electrode 114 (left posterior temporal region, coinciding with the lesion)
(f) Subdural electrode insertion with MRI coregistration. Cortical stimulation produced speech arrest over left anterior inferolateral temporal region (electrode 52), anterior to the lesion (electrode 114). FMRI