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Occipitotemporal epilepsy studied with stereotaxically implanted depth electrodes and successfully treated by temporal resection

A young woman had seizures suggestive of temporal lobe origin with some clinical features indicative of occipital onset. Electroencephalograms recorded through scalp and sphenoidal electrodes showed predominantly right posterior temporooccipital epileptogenic discharges. Stereotaxic depth electrode recordings from the right temporal and occipital lobes demonstrated that some seizures arose independently from either the temporal or occipital lobes. Most arose within the occipital lobe, but to become clinically evident, the seizure discharge had to spread to the temporal lobe. Following temporal lobe resection, including excision of limbic structures, the patient has remained seizure free for four years except for a few generalized seizures before and after delivery of her child.