Treatment decisions in epilepsy critically depend on information on the course of the disease, its severity and options for specific local interventions. We here report a patient with pharmaco-resistant non-lesional temporal lobe epilepsy with evidence for predominant right temporal epileptogenesis. While seizure frequency had been grossly underestimated for many years, ultralong-term monitoring with a subcutaneous EEG device revealed actual seizure frequency (66 over 11 months vs four patient-documented seizures), providing objective data on treatment efficacy and additional supportive lateralizing information that played a decisive role for the choice of surgical treatment, which had been rejected by the patient prior to this information.
Keywords: epilepsy treatment; seizure lateralization; subcutaneous EEG; ultralong-term EEG monitoring.
© 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.