Case Report: Stereoelectroencephalography and Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation in Familial Lateral Temporal Lobe Epilepsy

Abstract

Familial lateral temporal lobe epilepsy (FLTLE) is genetic focal epilepsy usually characterised by auditory symptoms. Most FLTLE cases can be controlled by anti-seizure medications, and to our best knowledge, there are no previous reports about stereoelectroencephalography (SEEG) used for patients with FLTLE. In this report, we present two patients with FLTLE in one family and their SEEG performances, together with 18F-fluorodeoxyglucose (18F-FDG) PET and MRI results. In case 1, fast activities originated from the right superior temporal gyrus and spread rapidly to the right anterior insular lobe and hippocampus. In case 2, there were two seizure patterns: (1) The fast activities or sharp slow waves were identified at the left superior temporal gyrus, then, sharp waves and spike waves spread in the left superior temporal gyrus; (2) There were fast activities and slow-wave oscillation originated in the left superior temporal gyrus, then, the fast activities spread in the left superior temporal gyrus and finally spread to the other sites. An SEEG-guided radiofrequency thermocoagulation was performed for both patients and one of them underwent resection surgery. Seizures are well-controlled and the patients are very satisfied with the therapeutic effects.