Multimodal approach leads to seizure-freedom in a case of highly refractory drug-resistant focal epilepsy

Kelsey M. Smith, Eva C. Alden, Hugh D. Simpson, Benjamin H. Brinkmann, Nicholas M. Gregg, Kai J. Miller, Brian N. Lundstrom

Research output: Contribution to journalArticlepeer-review


Drug-resistant, nonlesional, extratemporal lobe focal epilepsy can be difficult to treat and may require a high degree of multidisciplinary teamwork to localize the seizure onset zone for resective surgery. Here, we describe a patient with longstanding drug-resistant, nonlesional, extratemporal focal epilepsy with a high seizure burden who became seizure-free after prolonged evaluation and eventual left frontal cortical resection. Prior evaluations included magnetoencephalography, invasive video-EEG monitoring, and implantation of a responsive neurostimulation (RNS) device for ongoing intracranial stimulation. Highly sophisticated techniques were utilized including stereotactic localization of prior evaluations to guide repeat stereo-EEG (SEEG), electrical stimulation mapping, SEEG-guided radiofrequency ablation, and awake resection with language and motor mapping using a cognitive testing platform . Incorporating a wide array of data from multiple centers and evaluation time periods was necessary to optimize seizure control and minimize the risk of neurological deficits from surgery.

Original languageEnglish (US)
Article number100570
JournalEpilepsy and Behavior Reports
StatePublished - Jan 2022


  • Awake cortical resection
  • Electrical stimulation mapping
  • Epilepsy surgery
  • SEEG
  • SEEG-guided radiofrequency ablation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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