Abstracts

Rationale: In patients with intractable seizures, differentiating idiopathic generalized epilepsy (IGE) vs frontal lobe epilepsy is important to determine surgery candidacy. We present a series of patients that illustrate this relatively common dilemma encountered at referral epilepsy centers.Methods: We collected and reviewed patients whose EEG-video monitoring and presurgical evaluation led to the question of IGE vs. frontal lobe epilepsy.Results: See table Conclusions: These patients present with generalized tonic clonic seizures, early age of onset, and various amounts of asymmetries clinically or electrically, but in the absence of an MRI lesion, it is difficult or impossible to prove whether they have a focal (frontal lobe) onset that could be amenable to surgery. Some centers prefer to err on the side of IGE and treat with broad-spectrum AEDs, while others may pursue this with very invasive (bifrontal) EEG recordings.