False Lateralization of Mesial Temporal Lobe Epilepsy by Noninvasive Neurophysiological Examinations : Case Report
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概要
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Mesial temporal lobe epilepsy (mTLE) is the most common form of symptomatic localization-related epilepsy and is surgically remediable. Lateralization of the seizure onset is particularly important to determine from a surgical perspective. A 39-year-old woman with intractable mTLE first exhibited seizure at the age of 3 years. She experienced epigastric sensation and placed her right hand on her abdomen before falling backward. Although interictal scalp electroencephalography (EEG), sphenoidal scalp ictal EEG, and magnetoencephalography showed right temporal side focus, computed tomography and magnetic resonance imaging showed atrophy of the left cerebral hemisphere. Single photon emission computed tomography with technetium-99m ethyl cysteinate dimmer and I-123 iomazenil showed obscure focus on the left side. As a discrepancy existed between the results of neurophysiological examinations and imaging, we performed subdural electrode implantation on the bilateral temporal lobe. Although a bemegride-induced seizure arose from the right side during the subdural recording, the onset of 5 habitual seizures was observed in the left hippocampus. On the basis of these results, the seizure was diagnosed as left mTLE, and left anterior temporal lobectomy and amygdalohippocampectomy were performed. The patient has been free from the seizures for more than 1.5 years of follow up. Bilateral subdural electrode measurement of habitual seizures is indispensable for clarifying the actual focus when a discrepancy exists between neuroimaging and noninvasive neurophysiological examinations.
- 社団法人 日本脳神経外科学会の論文
- 2006-10-15
著者
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MASUDA Hiroshi
Department of Fermentation Technology, Yamanashi University
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KAMEYAMA Shigeki
Department of Neurosurgery, Epilepsy Center in National Nishi-Niigata Chuo Hospital
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SASAGAWA Mutsuo
Department of Psychiatry, National Nishi-Niigata Central Hospital
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Fujimoto Ayataka
Department Of Neurosurgery Epilepsy Center Nishi-niigata Chuo National Hospital
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Kameyama Shigeki
Department Of Neurosurgery Epilepsy Center Nishi-niigata Chuou National Hospital
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Kameyama Shigeki
Department Of Neurosurgery Epilepsy Center Nishi-niigata Chuou National Hospital
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Kameyama Shigeki
Department Of Neurosurgery Brain Research Institute Niigata University
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Sasagawa Mutsuo
Department Of Psychiatry Epilepsy Center Nishi-niigata Chuo National Hospital
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Kameyama Shigeki
Department Of Neurosurgery Sannocho Hospital
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HOMMA Jumpei
Department of Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital
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Homma Jumpei
Department Of Neurosurgery Epilepsy Center Nishi-niigata Chuo National Hospital
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Kameyama Shigeki
Department Of Functional Neuro-surgery
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Masuda Hiroshi
Department Of Agricultural Chemistry Obihiro University Of Agriculture And Veterinary Medicine
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Masuda Hiroshi
Department Of Neurosurgery Epilepsy Center Nishi-niigata Chuo National Hospital
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