Non-dominant, Lesional Neocortical Temporal Lobe Epilepsy

We describe a patient with pharmacoresistant epilepsy caused by a newly described entity, multinodular and vacuolating neuronal tumor of the cerebrum. This chapter discusses the clinical manifestations, histopathological and radiological findings, and management of this novel entity. We investigate ictal semiologies such as fear, déjà vu, coughing, mirthless high-pitched laughter, and immobility. The distinction between ictal tonic and dystonic posturing is highlighted. The neuroimaging distinctions between focal cortical dysplasia and dysembryoplastic neuroepithelial tumor are discussed. This case serves as an illustration of the spatiotemporal dynamics of the epileptic network. Lastly, we discuss in-depth ictal and interictal high-frequency oscillations, their occurrence with and without spikes, their impact on the surgical decision-making process, and their significance within the epileptic network.