Monthly Case

A 41-year-old female patient suffers from intractable epilepsy for more than 15 years. During the seizures she is absent, her husband describes starring, unresponsiveness, as well as chewing and smacking. Duration of seizures is 1 min., frequency is 4-5 monthly. In the past years, the patient had been treated with multiple antiepileptic drugs, at last she was taking three antiepileptics simultaneously.

Longterm video-EEG with scalp electrodes revealed seizure onset in the right temporal lobe, however the seizure onset zone was rather broad. Neuroimaging (MRI) did not show any structural lesion and thus did not help to localise the region of seizure origin. In a second step, EEG was recorded with intracranial electrodes from subdural structures. This diagnostic approach helped to identify the epileptogenic region precisely. Subsequently, parts of the right temporal lobe were resected.

This operation was performed 1 year ago. Since then, the patient did not suffer from any further epileptic seizures. During her visits in our epilepsy outpatient clinic, the patient repeatedly reports that she feels “as newly born”. Currently, she is treated with two antiepileptic drugs, this combination will be continued for at least one more year.

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