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Clinical impact of a high-frequency seizure onset zone in a case of bitemporal epilepsy

Premysl Jiruska, Martin Tomasek, David Netuka, Jakub Otahal, John GR Jefferys, Xiaoli Li, Petr Marusic

. 2008 ; 10 (3) : 231-238.

Language English Country France

Document type Case Reports, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc14067182

Grant support
NR8843 MZ0 CEP Register

High-frequency activity has been described as having a role in the initiation of epileptic seizures. The case of a patient with refractory bitemporal epilepsy is presented. Extraoperative monitoring with depth and subdural electrodes revealed an ictal pattern with a build-up of high-frequency (> 80 Hz) activity originating in the cortex, with spread to both hippocampi. This observation was only revealed with the use of high-pass filtering, and represented crucial information that significantly influenced the decision about the side, localization and extent of resection. Removal of the cortex generating high-frequency activity, led to cessation of seizures in this patient. Current knowledge about the role of high-frequency activity and the case presented here support the importance of recording with equipment capable of detecting fast activity during the presurgical invasive monitoring. An active search for a high-frequency seizure onset zone in patients with structurally-unaffected hippocampi may improve the outcome beyond that possible with conventional bandwidth, invasive EEG recordings.

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$a Jiruška, Přemysl, $d 1976- $7 xx0037786 $u Department of Neurophysiology, Division of Neuroscience, School of Medicine, The University of Birmingham, Birmingham, United Kingdom. p.jiruska@bham.ac.uk
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$a Clinical impact of a high-frequency seizure onset zone in a case of bitemporal epilepsy / $c Premysl Jiruska, Martin Tomasek, David Netuka, Jakub Otahal, John GR Jefferys, Xiaoli Li, Petr Marusic
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$a High-frequency activity has been described as having a role in the initiation of epileptic seizures. The case of a patient with refractory bitemporal epilepsy is presented. Extraoperative monitoring with depth and subdural electrodes revealed an ictal pattern with a build-up of high-frequency (> 80 Hz) activity originating in the cortex, with spread to both hippocampi. This observation was only revealed with the use of high-pass filtering, and represented crucial information that significantly influenced the decision about the side, localization and extent of resection. Removal of the cortex generating high-frequency activity, led to cessation of seizures in this patient. Current knowledge about the role of high-frequency activity and the case presented here support the importance of recording with equipment capable of detecting fast activity during the presurgical invasive monitoring. An active search for a high-frequency seizure onset zone in patients with structurally-unaffected hippocampi may improve the outcome beyond that possible with conventional bandwidth, invasive EEG recordings.
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$a Netuka, David $7 xx0061783 $u Department of Neurosurgery, 1st Faculty of Medicine, Charles University, Central Military Hospital, Prague, Czech Republic
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$a Otahal, Jakub $u Department of Developmental Epileptology, Institute of Physiology, Czech Academy of Science, Prague, Czech Republic
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$a Jefferys, John G. R. $u Department of Neurophysiology, Division of Neuroscience, School of Medicine, The University of Birmingham, Birmingham, United Kingdom
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$a Li, Xiaoli $u Cercia, School of Computer Science, The University of Birmingham, Birmingham, United Kingdom
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$a Marusič, Petr, $d 1966- $7 mzk2004217966 $u Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol Hospital, Prague, Czech Republic; Department of Neurosurgery, 1st Faculty of Medicine, Charles University, Central Military Hospital, Prague, Czech Republic
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