Abstract

A 17-year-old woman developed left hemiparesis at the age 6 months. She had suffered from focal motor seizures associated with tonic extension of her left extremities since the age of 10 years. The interictal scalp EEG demonstrated frequent spike-and-slow-wave complexes dominantly in the right frontal area. MRI showed an old cerebral infarction in the right frontal lobe. Simultaneous recordings of magnetoencephalography (MEG) and EEG were obtained by using a 204-channel whole-head MEG system. Equivalent current dipoles (ECDs) calculated from epileptic spikes on MEG were scattered in the cortex adjacent to the lesion in the right frontal lobe. Positron emission tomography with 18-fluoro-2-deoxyglucose (FDG-PET) in the interictal state showed hypometabolism in the lesion and its adjacent area. The super-imposed images of the dipole and PET showed that epileptic foci surrounded the lesion. The multimodality imaging is useful for evaluation of patients with epilepsy for possible indication of surgery.