A case of intractable epilepsy of linguistic area origin

  This patient had intractable epilepsy of speech area origin, evaluated in 2007, with bifrontal craniotomy and buried intracranial electrodes, and postoperatively found to originate in the left lower precentral gyrus, which is a primary motor area, and a slightly larger resection would have resulted in postoperative hemiparesis and aphasia. A small resection of the lower precentral gyrus cortex was ineffective postoperatively, but there was no hemiparesis and no aphasia. By 2014 still dozens of seizures per day. Again evaluated in our department. It was considered that the epileptic foci left Broca area, due to two previous surgeries and severe intracranial adhesions, could not be reopened to bury electrodes and only SEEG technique could be applied to bury intracranial electrodes. The focal origin was monitored postoperatively. The seizure foci (Broca and primary motor areas) were precisely localized with the help of SEEG again, and the seizures disappeared after removal of the foci without hemiparesis. There was postoperative transcortical motor aphasia, which gradually recovered after surgery. Normal speech conversation was basically restored about one month after surgery. There is no way to operate again in this case without the assistance of SEEG technique. Therefore SEEG technique has unique advantages in certain patients.