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Temporal lobe Epilepsy Frontal lobe Medicine Electroencephalography Insula Lobe Psychology Wakefulness Rhythm Neuroscience Anatomy Tonic (physiology) Audiology Internal medicine

Hardik Doshi , Meghan Kataria , Aashit Shah , Deepti Zutshi ·

YOU? · · 2020 · Open Access · · DOI: https://doi.org/10.1212/cpj.0000000000000792 · OA: W2993760789

A 32-year-old man presents with intractable right temporal lobe epilepsy of currently unknown etiology described as focal unaware seizures with teeth grinding and rhythmic left leg movements with and without spread to bilateral tonic-clonic (video 1). The patient and caregivers report episodes of bruxism during wakefulness and sleep. MRI shows an incidental left frontal developmental venous anomaly, and the temporal lobes are symmetrical with normal architecture and without signal abnormalities. Fluorodeoxyglucose-PET shows hypometabolism in the lateral right temporal lobe, right medial prefrontal cortex, and adjacent lateral/inferior frontal cortex and insula. Video EEG captured 6 right temporal lobe seizures (figure).