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Partial epilepsy presenting as focal atonic seizure: a case report
Jun Zhao1, Pegah Afra, Bola Adamolekun
1Department of Neurology, University of Tennessee Health Science Center, 415 Link Building, 855 Monroe Avenue, Memphis, TN 38163, USA.
Seizure
|July 15, 2010
Summary
This study reports a case of frontal lobe atonic seizures identified via video-EEG monitoring. Diffusion tensor imaging (DTI) revealed no significant white matter differences in the frontal lobes.
Area of Science:
- Neurology
- Neurophysiology
- Neuroimaging
Background:
- Atonic seizures are a challenging epilepsy subtype.
- Frontal lobe epilepsy (FLE) can present with diverse seizure semiologies.
- Video-electroencephalography (video-EEG) monitoring is crucial for seizure localization.
Observation:
- A 38-year-old female presented with intractable atonic seizures, including facial grimacing and head drop.
- Video-EEG monitoring localized seizure onset to the right frontal lobe.
- EEG showed spike-and-wave discharges correlating with seizure activity, resembling epileptic negative myoclonus.
Findings:
- Routine MRI was normal, prompting diffusion tensor imaging (DTI) of the frontal white matter.
- Fractional anisotropy and diffusivity measures showed no significant interhemispheric differences in normal-appearing white matter.
- This suggests intact white matter integrity despite focal epileptic activity.
Implications:
- The findings challenge assumptions about white matter abnormalities in FLE with normal MRI.
- Further research is needed to understand the pathophysiology of atonic seizures in this context.
- DTI may have limitations in detecting subtle white matter changes associated with certain epilepsy types.
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