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Updated: May 19, 2026
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Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
Cryptogenic West syndrome and subsequent mesial temporal lobe epilepsy
Takashi Agari1, Katsuhiro Kobayashi, Kiyoko Watanabe
1Department of Neurological Surgery.
Epileptic Disorders : International Epilepsy Journal with Videotape
|September 4, 2012
Summary
This case study details a patient with epilepsy, linking infantile West syndrome to later mesial temporal lobe epilepsy. Surgical intervention led to seizure freedom, suggesting an underlying lesion.
Area of Science:
- Neurology
- Epileptology
- Neuroscience
Background:
- West syndrome, a severe infant epilepsy, is often cryptogenic.
- Mesial temporal lobe epilepsy (MTLE) is a common epilepsy syndrome.
- MRI-negative epilepsy presents diagnostic challenges.
Purpose of the Study:
- To report a unique case of cryptogenic West syndrome followed by MTLE.
- To investigate the potential link between early epilepsy syndromes and later-onset epilepsy.
- To highlight diagnostic and treatment considerations for MRI-negative epilepsy.
Main Methods:
- Case report of a male patient with a history of epilepsy.
- Utilized scalp electroencephalography (EEG) and magnetic resonance imaging (MRI).
- Performed invasive EEG monitoring and subsequent temporal lobectomy.
Main Results:
- Patient presented with complex partial seizures and bilateral temporal spikes on EEG.
- MRI revealed no organic brain lesion; invasive EEG showed right hippocampal onset.
- Resected specimen showed gliosis and corpora amylacea, without hippocampal sclerosis.
Conclusions:
- An epileptogenic lesion may cause MRI-negative MTLE and apparent cryptogenic West syndrome.
- Surgical resection of the right temporal lobe resulted in seizure freedom.
- This case expands understanding of epilepsy progression and etiology.
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