[Frontal seizures recorded by magnetoencephalography. Case report]. / Crisis frontales registradas mediante magnetoencefalografía. Caso clínico.

INTRODUCTION: This paper reports the usefulness of magnetoencephalography (MEG) in the anatomical localization of the onset and spread of seizures. CASE REPORT: In a 34-year-old male patient who suffered from drug-resistant complex partial seizures (sometimes generalized) with loss of awareness, magnetic resonance imaging revealed a probable left frontobasal cortical dysplasia. Ictal scalp electroencephalogram showed left frontotemporal theta waves. Electrocorticography (ECoG) registered interictal polyspike discharges and located the seizure onset in the lateral orbital side of the left frontal lobe. Three seizures were registered by MEG, clinically similar to the ones usually experienced by the patient. MEG ictal spike dipole location showed seizure onset coming from the left inferior frontal gyrus (as the ECoG), spreading on to other frontal areas, insula and temporal lobe, all in the left hemisphere. CONCLUSION: MEG may be considered as a useful diagnosis modality in the study of partial seizure physiopathology as well as in its presurgical evaluation.

Crisis frontales registradas mediante magnetoencefalografía. Caso clínico / Frontal seizures recorded by magnetoencephalography. Case report

Introducción. Este artículo expone un ejemplo de la utilidadde la magnetoencefalografía (MEG) en la localización anatómicadel inicio y la propagación de las crisis epilépticas. Caso clínico.Se trata de un paciente de 34 años con crisis parciales complejas farmacorresistentes.La resonancia magnética presenta una probabledisplasia cortical frontobasal izquierda. El electroencefalograma ictalde superficie revela ondas theta frontotemporales izquierdas. Enel registro con electrodos subdurales se demuestra la existencia deanomalías epileptiformes interictales durante el sueño, entre las quepredominan las polipuntas, y crisis de inicio focal en la cara lateroorbitariadel lóbulo frontal izquierdo. La MEG registra tres crisis clínicamentesimilares a las experimentadas por el paciente y permitelocalizar el inicio de las crisis en la circunvolución frontal inferiorizquierda, con propagación a otras áreas frontales, la ínsula y ellóbulo temporal, todo ello en el hemisferio izquierdo. Conclusión. LaMEG puede considerarse como un elemento diagnóstico útil en el estudiode la fisiopatología de las crisis parciales, así como en la evaluaciónprequirúrgica

Introduction. This paper reports the usefulness of magnetoencephalography (MEG) in the anatomical localization ofthe onset and spread of seizures. Case report. In a 34-year-old male patient who suffered from drug-resistant complex partialseizures (sometimes generalized) with loss of awareness, magnetic resonance imaging revealed a probable left frontobasalcortical dysplasia. Ictal scalp electroencephalogram showed left frontotemporal theta waves. Electrocorticography (ECoG)registered interictal polyspike discharges and located the seizure onset in the lateral orbital side of the left frontal lobe. Threeseizures were registered by MEG, clinically similar to the ones usually experienced by the patient. MEG ictal spike dipolelocation showed seizure onset coming from the left inferior frontal gyrus (as the ECoG), spreading on to other frontal areas,insula and temporal lobe, all in the left hemisphere. Conclusion. MEG may be considered as a useful diagnosis modality in thestudy of partial seizure physiopathology as well as in its presurgical evaluation