[A special case of frontal lobe epilepsy]

We present clinical, electrophysiological and neuropsychological data of a patient with an extraordinary type of frontal lobe epilepsy. In addition to complex partial and secondary generalized seizures the patient had 183 non-convulsive states per day. Chronical electrocorticography via subdural electrodes clearly revealed that the complex partial seizures and the secondary generalized seizures originated within the right frontal lobe. During the non-convulsive states a constantly increasing spike frequency which showed characteristics of secondary bilateral synchrony was noticed within both frontal lobes. After a period of 20-40 min a sudden transition into a clinically generalized seizure occurred. In contrast to the clinical generalization the onset of bilateral motor phenomena was paralleled by a "secondary focalisation" of the pre-existent high frequency interictal bifrontal epileptiform activity within the right frontal lobe.