Abstract
Background: Non-lesional epilepsy or MRI-negative epilepsy is characterized by the absence of a potentially epileptogenic lesion. In these cases surgical procedures are more complex and rather challenging. Case Description: A 6-year-8-monthold boy presented with refractory epilepsy since 8 months-old onset age was 8 months. Crises were predominantly complex partial seizures. Patient had no focal neurological signs but showed cognitive, learning and behavioral alterations. Video-EEG: left temporal-occipital focus radiating to the right. MRIs did not show lesion, interictal PET was negative and ictal SPECT showed left occipital and right temporal focuses, which was interpreted as propagation. Resection surgery of left focus was performed in two stages, withsubdural grid electrodes. Histopathological studies showed cortical dysplasia type IA. Follow-up (24 months): the patient presented only one annual seizure and showed cognitive, learning and behavioral improvement. Conclusion: In this case SPECT was very useful in localizing epileptogenic focus.
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