Analysis of dynamics and propagation of parietal cingulate seizures with secondary mesial temporal involvement

• Published in: Epilepsy & behavior Vol. 14; no. 1; pp. 108 - 112
• Main Authors: Koubeissi, Mohamad Z, Jouny, Christophe C, Blakeley, Jaishri O, Bergey, Gregory K
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2009
• Subjects: Anticonvulsants - therapeutic use; Confusion - etiology; Confusion - psychology; Data Interpretation, Statistical; Depth electrodes; Electrodes, Implanted; Electroencephalography; Epilepsy, Temporal Lobe - pathology; Epilepsy, Temporal Lobe - psychology; Epilepsy, Temporal Lobe - surgery; Gabor atom density; Gyrus Cinguli - pathology; Gyrus Cinguli - surgery; Hippocampus - pathology; Hippocampus - physiopathology; Humans; Magnetic Resonance Imaging; Male; Matching pursuit; Neurology; Neurosurgical Procedures; Parietal Lobe - pathology; Parietal Lobe - surgery; Posterior cingulate seizures; Seizure dynamics; Seizures - pathology; Seizures - psychology; Seizures - surgery; Treatment Outcome; Young Adult; Gabor atom density; Posterior cingulate seizures; Seizure dynamics; Depth electrodes; Matching pursuit
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2008.08.021

Abstract Cingulate-onset seizures, particularly those originating from parietal cingulate regions, are inadequately described and confounded by patterns of propagation. We analyzed scalp and depth electrode recordings in a patient whose seizures originated from a lesion in the right posterior cingulate region and produced secondary seizure activity in ipsilateral mesial temporal structures. Analyses included the matching pursuit (MP) method of time–frequency decomposition and the Gabor atom density (GAD) measure of signal complexity. Although scalp recordings suggested a right temporal onset, seizures recorded with depth electrodes clearly began in the parietal cingulate region before producing a secondary discharge in ipsilateral mesial structures. GAD revealed a significant increase in complexity during ictal cingulate activity and a consistent pattern of subsequent complexity changes in the hippocampus 30 seconds later. MP and GAD measures were valuable supplements to confirm the stereotyped pattern of both time–frequency changes and complexity. This provides additional evidence for pathways between the parietal cingulate region and mesial temporal structures and raises questions as to whether parietal cingulate seizures can produce clinical symptoms independent of regional or remote propagation.