Clinical and electrophysiological characteristics of epileptic seizures arising from diagonal sulci_Journal of Epilepsy

Authors：

 ZHUANG Jun ¹ , FEI Lingxia ¹ , LI Shaochun ² , HUA Gang ² , CAI Meiling ¹ , LI Sixian ³ , WANG Yuanqing ³

1. Department of Epilepsy, Guangdong Sanjiu Brain Hospital, Guangzhou 510510, China;
2. Department of Epilepsy Surgery, Guangdong Sanjiu Brain Hospital, Guangzhou 510510, China;
3. Department of Functional Neurology, Shenzhen Second People’s Hospital, Shenzhen 518035, China;

Corresponding author：

ZHUANG Jun, Email: nuanyun1983@163.com

Keywords：

Diagonal sulci; Frontal epilepsy; Stereo-electroencephalography; Clinical characteristics; Electrophysiological characteristics

DOI：

10.7507/2096-0247.202304006

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Objective To research clinical manifestations, electrophysiological characteristics of epileptic seizures arising from diagonal sulci (DS), to improve the level of the diagnosis and treatment of frontal epilepsy. Methods We reviewed all the patients underwent a detailed presurgical evaluation, including 5 patients with seizures to be proved originating from diagonal sulci by Stereo-electroencephalography (SEEG). All the 5 patients with detailed medical history, head Magnetic resonance (MRI), the Positron emission computered tomography (PET-CT) and psychological evaluation, habitual seizures were recorded by Video-electroencephalography (VEEG) and SEEG, we review the intermittent VEEG and ictal VEEG, analyzing the symptoms of seizures. Results 5 patients were divided into 2 groups by SEEG, group 1 including 3 patients with seizures arising from the bottom of DS, group 2 including 2 patients with seizures arising from the surface of DS, all the tow groups with seizures characterized by both having tonic and complex motors, tonic seizures were prominent in seizures from left DS, and tonic seizures may absent in seizures from right DS. Intermittent discharges with group1 were diffused, and intermittent discharges with group 2 were focal, but both brain areas of frontal and temporal were infected. Ictal EEG findings were consistent with the characteristics of neocortical seizures, the onset EEG shows voltage attenuation, seizures from bottom of DS with diffused EEG onset, and seizures from surface of DS with more focal EEG onset, but both frontal and anterior temporal regions were involved. Conclusion the symptom of seizures arising from DS characterized by tonic and complex motor, can be divided into seizures arising from the bottom of DS and seizures from the surface of DS, with different electrophysiological characters.

Citation： ZHUANG Jun, FEI Lingxia, LI Shaochun, HUA Gang, CAI Meiling, LI Sixian, WANG Yuanqing. Clinical and electrophysiological characteristics of epileptic seizures arising from diagonal sulci. Journal of Epilepsy, 2023, 9(4): 281-286. doi: 10.7507/2096-0247.202304006 Copy

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1. Lüders H, Acharya J, Baumgartner C. Semiological Seizure Classification. Epilepsia, 1998, 39(9): 1006-1013.
2. Chauvel P, Trottier S, Vignal JP, et al. Somatomotor seizures of frontal lobe origin. Adv Neurol, 1992, 57: 185-232.
3. Chauvel P, Kliemann F, Vignal JP, et al. The clinical signs and symptoms of frontal lobe seizures. Phenomenology and classification. Adv Neurol, 1995, 66: 115–125; discussion 125–126.
4. Amiez C, Kostopoulos P, Champod AS, et al. Local morphology predicts functional organization of the dorsal premotor region in the human brain. Neurosci, 2006, 26: 2724-2731.
5. Amunts K, Schleicher A, Bürgel U, et al. Broca’s region revisited: cytoarchitecture and intersubject variability. Comp Neurol, 1999, 412: 319-341.
6. Trisanna SM, Michael P. Morphological patterns and spatial probability maps of two defining sulci of the posterior ventrolateral frontal cortex of the human brain: the sulcus diagonalis and the anterior ascending ramus of the lateral fissure. Brain Structure and Function, 2018, doi. org/10.1007/s00429-018-1733-y.
7. Cordell M, Baker MD, Joshua D, et al. A connectomic atlas of the human cerebrum—chapter 2: the lateral frontal lobe. J Operative Neurosurgery, 2018, 15: S10-S74.
8. Coderre EL, Smith JF, van Heuven WJ, et al. The functional overlap of executive control and language processing in bilinguals. Biling (Camb Engl), 2016, 19(3): 471-488.
9. Cordell M Baker, Joshua MD, Burks M , et al. Connectomic Atlas of the Human Cerebrum—Chapter 5: The Insula and Opercular Corte. Operative Neurosurgery, 2018, 15(Suppl 1): S175-S244.
10. Francesca B, Aileen Mc, Agnes T, et al. Frontal lobe seizures: from clinical semiology to localization. Epilepsia, 2014, 55(2): 264-277.

Journal of Epilepsy

Clinical and electrophysiological characteristics of epileptic seizures arising from diagonal sulci

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