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Pearls and Oy-sters: The chapeau de gendarme sign and other localizing gems in frontal lobe epilepsy

A 28-year-old right-handed woman with a history of medically intractable localization-related epilepsy was admitted to the epilepsy monitoring unit (EMU) for continuous video-EEG, with the aim of characterizing her seizures and evaluating her surgical eligibility. Her seizures began when she was 18 months of age. There were no perinatal complications, and she attained normal cognitive and motor developmental milestones. Her history was negative for febrile seizures, significant head trauma, or CNS infections. No family history of a seizure disorder was present. She had failed several antiepileptic medications that achieved therapeutic dosing levels, including but not limited to carbamazepine, clonazepam, levetiracetam, and eslicarbazepine.