Table 1.
Patient | Semiology | EEG | PET | MRI | AP | Follow up (Engel) | EZ (by Reference standard) | Injection time (s) | Visual analysis | SISCOM-SPM analysis | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No. | Age range | Ictal | Interictal | Side | Lobe | ||||||||
1 | 31–35 | Autonomic aura (dizziness), aphasia and impaired awareness | Left Fronto-Temp | Left Fronto-Temp | Left Temp-Par | Left Frontal CxThick | – | – | Left | Frontal | 4 | Discordant | Concordant |
2 | 36–40 | Right upper limb clonic movement, versive head posture to right side, impaired awareness | Left Fronto-TempRight FrontalGen | Bil FrontalGen | Right Temp | Right Fronto-Temp FCD | HS + FCD IIIA | III-A | Right | Temp | 5 | Concordant | Concordant |
3 | 36–40 | Jamais vù, bilateral manual automatisms | Left Temp | Left Temp Bil Temp | Left Temp | Left Frontal FCD | – | – | Left | Temp | 5 | Discordant | Concordant |
4 | 21–25 | Epigastric sensation aura, impaired awareness, right hand automatisms | Bil Fronto-Temp Right Fronto-Temp | Left TempBil Temp | Right Temp | Right Temp FCD | – | – | Right | Temp | 10 | Concordant | Concordant |
5 | 26–30 | Epigastric and right cephalic sensations, impaired awareness, bilateral manual automatisms, BTCS | Left TempRight Temp | Left Temp | Left Temp | Left Temp CxThick | – | – | Left | Temp | 60 | Concordant | Concordant |
6 | 46–50 | Verbal (repetitive speech) and bilateral manual automatisms, impaired awareness | Bil TempRight Temp | Bil Temp | Right Temp | Right HA | – | – | Right | Temp | 3 | Concordant | Concordant |
7 | 46–50 | Epigastric (malaise) and cephalic sensation (light headedness), impaired awareness | Left Temp | Left Temp | Bil Frontal* | EncBil Frontal* | – | – | Left | Temp | 28 | Concordant | Concordant |
8 | 11–15 | Atonic (trunk and head) seizures and BTCG | Right Temp-Par* | Right Temp-OcpLeft Temp-Ocp | Right Temp Right Ins | Right Ins FCD | – | – | Right | Ins | 21 | Discordant | Concordant |
9 | 36–40 | Epigastric sensation, impaired awareness, BTCS | Right Temp | Right Temp | NL | Right Temp FCD | – | – | Right | Temp | 15 | Concordant | Discordant |
10 | 21–25 | Epigastric sensation, aphasia, BTCS | Left Fronto-Par | Left Fronto-Temp | Left Temp-Ocp | Left Temp Enc | – | – | Left | Temp | 4 | Concordant | Concordant |
11 | 1–5 | Agitation (look for the mother), four limbs tonic posture | Right Frontal | Right HemRight Temp-Ocp | – | TS | Frontal, Ocp TS | I-A | Right | Frontal Ocp | 10 | Partially concordant | Concordant |
12 | 26–30 | Visual hallucination, impaired awareness, BTCS | Left Frontal | Left Fronto-Temp | Left Hem | Left Temp FCD* | – | – | Left | Frontal | 22 | Concordant | Concordant |
13 | 31–35 | Autonomic aura (thoracic discomfort), visual hallucination, clonic left upper limb and jaw movements | Right Hem | Right Fronto-Temp Right Par-Ocp | Right Hem > Ins | Right Hem Atrophy (>Temp + Amg)* | – | – | Right | Ins | 13 | Discordant | Concordant |
14 | 26–30 | Behavior arrest, BTCS (nocturnal seizures) | Left Frontal | Left Fronto-TempBil Frontal | Left Frontal | Left Frontal FCD | – | – | Left | Frontal | 20 | Discordant | Discordant |
15 | 46–50 | Autonomic aura (tachycardia, sweating), impaired awareness, BTCS | Right Temp | Right Temp | Right Temp | Right HA | – | – | Right | Temp | 34 | Concordant | Concordant |
16 | 21–25 | Right jaw tonic movement, right cephalic version, BTCS (nocturnal seizures) | Left Frontal | Bil Frontal | Left Temp-Ocp>Ins | Left Temp-OcpFCD* | – | – | Left | Ins | 8 | Discordant | Concordant |
17 | 51–55 | Emotional onset (fear), impaired awareness, BTCS | Left Temp | Bil Temp | – | Left HA | Left HS | I-A | Left | Temp | 20 | Concordant | Concordant |
18 | 26–30 | Behavior arrest, left ocular version, BTCS | Left Temp | Left Temp | Left Temp | Bil HA | – | – | Left | Temp | 41 | Concordant | Discordant |
19 | 21–25 | Atonic seizures/behavior arrest/Left upper limb clonic movements/facial clonic movements (majority left sided)/BTCS | Gen | MfGen | Bil Temp | Right Frontal FCD + Diffuse Atrophy | Callosotomy | III-A* | LeftRightRight | TempTempFrontal | 14 | Partially concordant | Partially concordant |
20 | 31–35 | Emotional onset (fear), autonomic sensation (thoracic discomfort), impaired awareness, BTCS | Bil Temp | Left Fronto-Temp | Bil Temp | NL | – | – | Left | Temp | – | Concordant | Concordant |
21 | 16–20 | Sensory (gustative) and Autonomic (sialorrhea) onset, bilateral clonic movements, impaired awareness, BCTS | Right Hem | Right Temp | Right Fronto-Temp | Right Frontal, Ins FCD | CE | III-A* | Right | FrontalTemp | 28 | Partially concordant | Discordant |
22 | 21–25 | Autonomic aura (vertigo), impaired awareness | Left Temp-Ocp | Left Temp | Left Temp Left Ins | Left Temp Post FCD | – | – | Left | Ins | 2 | Discordant | Concordant |
23 | 51–55 | Cognitive onset (jamais vù, aphasia), impaired awareness, BTCS | Left Temp | Bil Temp | – | Left HA | Left HS | I-A | Left | Temp | 24 | Concordant | Concordant |
Semiology description according to Blume et al. (22) and Fisher et al. (23).
BTCS, bilateral tonic-clonic seizure; Bil, bilateral; Hem, hemisphere; Gen, generalized; Mf, multifocal; NL, normal; Temp, temporal lobe; Frontal, frontal lobe; Par, parietal lobe; Ocp, occipital lobe; Ins, insular lobe; Fronto-Temp, Frontal and temporal lobes; Post, posterior; Amg, amygdala; CxThick, focal cortical thickening; Enc, encephalomalacia; HA, hippocampal atrophy; HS, hippocampal sclerosis; FCD, focal cortical dysplasia; TS, Tuberous Sclerosis; CE, Chronic encephalitis; (>Temp + Amg), more evident in the Temporal lobe and Amygdala; (>Ins.), more evident in the Insula.
cases explained in greater detail in the Supplementary Material.