Apparent False Lateralization of Seizure Onset by Scalp EEG in Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformation: A Case Report and Overview

Brain Sciences

Mariana Gaviria Carrillo¹  JesúsH. Rodríguez Q.¹  Ivan Gaona¹  Jonathan López²  Gloria Ortiz-Guerrero³  MauricioO. Nava-Mesa⁴ 

[1] Department of Neurology, Fundación Cardioinfantil (FCI), Bogotá 110131, Colombia;Department of Neurology, Universidad del Sinú, Cartagena 130001, Colombia;Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA;Escuela de Medicina y Ciencias de la Salud, GI en Neurociencias-NeURos, Universidad del Rosario, Bogotá 111221, Colombia;

关键词: cavernoma;    false lateralization;    epilepsy surgery;    scalp EEG;    refractory epilepsy;   

DOI  :  10.3390/brainsci10090584

来源: DOAJ

【 摘 要 】

False lateralization of ictal onset by scalp electroencephalogram (EEG) is an infrequent entity that has been reported in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (HS). In these cases, a tendency for rapid seizures that spread through the frontal-limbic system and hippocampal commissural pathways to the contralateral hemisphere has been proposed. Cerebral cavernous malformations (CCMs), which constitute a collection of abnormally configured small blood vessels with irregular structures, is a well-defined epilepsy-associated pathology. Their primary association with seizures might be explained either as a result of physiological changes affecting the cerebral cortex immediately surrounding the CCM (an epileptogenic mechanism that is relevant for both, temporal and extratemporal lesions) or as a result of promoting epileptogenicity in remote but anatomo-functionally connected brain regions, a mechanism that is particularly relevant for temporal lobe lesions. To date, there have been only two publications on falsely lateralizing ictal onsets by EEG in temporal cavernoma, but not in other regions. Here, we report a rare case of apparent false lateralization of ictal onset by scalp EEG in a patient with a left medial frontal gyrus cavernoma (supplementary motor area), and discuss some relevant pathophysiological mechanisms of false lateralization.

【 授权许可】

Unknown