1. Extratemporal Epilepsy
Eishi Asano, MD, PhD, MS
Associate Professor of Pediatrics and Neurology Wayne State University School of Medicine  Director, Electroneurodiagnostic Lab
Children's Hospital of Michigan

2. - Extratemporal lobe epilepsy - Idiopathic - Symptomatic
Focal epilepsy
- Extratemporal lobe epilepsy - Idiopathic
- Symptomatic
- Temporal lobe epilepsy
Generalized epilepsy
two types?

3. Idiopathic Childhood Epilepsy with
Central-Temporal Spikes
(Benign Rolandic Epilepsy)

4. Idiopathic Childhood Epilepsy with Central-Temporal Spikes
(Benign Rolandic Epilepsy)
Fp1-F7
F7-T3
T3-T5
T5-O1
Fp1-F3
F3-C3
C3-P3
P3-O1
Fz-Cz
Cz-Pz
Fp2-F4
F4-C4
C4-P4
P4-O2
Fp2-F8
F8-T4
T4-T6
T6-O2

5. Idiopathic Childhood Epilepsy with Central-Temporal Spikes
(Benign Rolandic Epilepsy) is characterized by …..?
Age
Seizure semiology
EEG
Neuropsychologically?
3 – 10 yr
Facial twitching during sleep > sGTC
Central-Temporal spike
Pt may have impairment.

7. Idiopathic Childhood Epilepsy with Occipital spikes
(Benign Occipital Epilepsy)
Do occipital spikes arise from
the left side
or the right side?
What additional montage will help you?

8. Idiopathic Childhood Epilepsy with Occipital Spikes
(Benign Occipital Lobe Epilepsy) is characterized by …..?
Age
Seizure semiology
EEG
Neuropsychologically?
3 – 10 yr
Visual Aura, Eye deviation,
Version, Vomiting > sGTC
Occipital spike
Pt may have impairment.

9. Extratemporal lobe epilepsy
Focal epilepsy
Extratemporal lobe epilepsy
-Frontal lobe epilepsy
-Parietal lobe epilepsy
-Occipital lobe epilepsy
-Multilobar epilepsy
Multilobar
Epilepsy
Symptomatic Generalized
Epilepsy (such as
Lennox-Gastaut syndrome)

10. Seizure video

11. Frontal lobe epilepsy
stereotyped semiology,
occurrence during sleep,
brief duration (often <30 seconds),
rapid secondary generalization,
prominent motor manifestations, and
complex automatisms.

12. Supplementary motor area (SMA)
unilateral or asymmetric bilateral tonic posturing
vocalization,
somatosensory aura;
complex automatisms such as kicking,
responsiveness often preserved

13. Primary motor cortex
simple partial motor seizures with
clonic or myoclonic movements preserved consciousness
secondary generalization is frequent

14. Medial frontal, cingulate, orbitofrontal regions
Complex behavioral events (bizarre)
gestural automatisms;
strong emotional feelings;
hypermotor activities (pelvic thrusting, pedaling, or thrashing, often accompanied by vocalizations or laughter/crying)

15. Autosomal dominant FLE
Brief nocturnal motor seizures
nicotinic acetylcholine receptor genes (nAChR alpha4 and beta2 subunits)

16. Parietal lobe epilepsy
Somatosensory aura
Vertigo aura
Visual aura
Then CPS or GTC

17. Parietal lobe epilepsy
Somatosensory aura
Vertigo aura
Visual aura
Then CPS or GTC

18. Occipital lobe epilepsy
Idiopathic Childhood Epilepsy with Occipital Spikes
(Benign Occipital Lobe Epilepsy) is characterized by …..?
Age
Seizure semiology
EEG
Neuropsychologically?
3 – 10 yr
Visual Aura, Eye deviation,
Version, Vomiting
Then sGTC
Occipital spike
Pt may have impairment.