Hippocampal seizure-onset laterality can change over long timescales: A same-patient observation over 500 days

Otis Smart; John D Rolston; Charles M Epstein; Robert E Gross

doi:10.1016/j.ebcr.2013.03.003

Hippocampal seizure-onset laterality can change over long timescales: A same-patient observation over 500 days

Epilepsy Behav Case Rep. 2013 Apr 13:1:56-61. doi: 10.1016/j.ebcr.2013.03.003. eCollection 2013.

Authors

Otis Smart¹, John D Rolston², Charles M Epstein³, Robert E Gross⁴

Affiliations

¹ Department of Neurosurgery, Emory University School of Medicine, Woodruff Memorial Research Building, 101 Woodruff Circle, Room 6329, Atlanta, GA 30322, USA.
² Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, M779, San Francisco, CA 94143, USA.
³ Department of Neurology, Emory University School of Medicine, Woodruff Memorial Research Building, 101 Woodruff Circle, Room 6217, Atlanta, GA 30322, USA.
⁴ Department of Neurosurgery, Emory University School of Medicine, Woodruff Memorial Research Building, 101 Woodruff Circle, Room 6311, Atlanta, GA 30322, USA.

Abstract

This study describes seizure laterality and localization changes over 500 consecutive days in a patient with bilateral temporal lobe epilepsy (BTLE) and implanted NeuroPace RNS™ System. During a continuous two-year time period, the RNS™ device stored 54 hippocampal electrocorticography (ECoG) seizures, which we analyzed to determine their distribution and time variance across hippocampi. We report nonrandom long-term seizure laterality and localization variations, especially in the first 200 days postimplant, despite equivalent total seizure counts in both hippocampi. This case suggests that hippocampal seizures dynamically progress over extensive timescales.

Keywords: Electrocorticography; Epilepsy; Laterality; Neurostimulation; Seizure; Shifting.

Abstract

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