Non-dominant, Lesional Posterior Quadrant Epilepsy

We describe a patient who developed pharmacoresistant non-dominant left posterior quadrant epilepsy due to a previously resected unruptured arterio-venous malformation. We briefly discuss possible epileptogenesis mechanisms in patients with arterio-venous malformations. Furthermore, we describe surgical interventions and outcome predictors to treat pharmacoresistant epilepsy in this cohort. Additionally, we briefly address the negative impact of topiramate on cognitive function. We examine the factors that contribute to language reorganization in epilepsy patients. Moreover, this case exemplifies the hypothesis of the crowding effect. We discuss the risks of the Wada test, focusing on transient encephalopathy. We present the available data on the clinical significance of electrographic seizures identified during intracranial monitoring and their relevance to surgical outcomes. We summarize the current state of knowledge regarding ictal termination, its patterns, and synchrony during intracranial monitoring. Finally, we analyze semiologies such as auditory hallucinations, auditory illusions, and ictal deafness.