Abstracts

Rationale: Background; Seizures arising from the frontal lobe are usually short in their duration. Purpose: To report a patient with unusually long duration seizures arising from frontal lobe. We present a patients with seizures arising from left frontal lobe whose seizures were lasting about 10 min that ware verified by subdural grid electrodes.Methods: A case report.Results: The patient is a right-handed, 33 year-old man who has epilepsy since the age of 18. He suffered form left frontal lobe abscess at the age of 18. His emphysema was surgically removed and diagnosis of bacterial infection was made. He developed epilepsy soon after he recovered from the acute phase of the illness. His seizures are characterized by generalized convulsion lasting about one minute. His seizures were relatively infrequent on antiepileptic medication in his third decade and seen only 3 times, however, the frequency increased to 3-6 times per year after the age of 30. Video EEG monitoring revealed no interictal spikes. Ictal recoding showed secondarily generalized tonic clonic seizures starting with head and eye version to right. The ictal EEG proceeded 13min before the clinical convulsion. The ictal pattern were rhythmic sharp waves and delta activities in the left frontal region, that ware clearly judged as ictal EEG pattern. The ictal recording by subdural electrodes recording also showed ictal pattern lasting more than 10 min. The patient remained conscious and could speak during the 10 min when EEG showed ictal pattern before the secondarily generalization. The patient underwent surgical resection of the left frontal seizure focus delineated by the evaluation, and seizure free for one year.Conclusions: We report a patient with seizures arising from frontal lobe which last unusually long duration verified by subdural electrode ictal recordings. The case add an insight to the notion of frontal lobe epilepsy.