case_images: PMC8599590_01
case_images: (A) A 2-min view of the EEG pattern with polygraphy of a left temporal lobe seizure characterized by rhythmic theta and delta activity on left fronto-temporal regions in patient 1. This long-lasting apnea induces a severe oxygen desaturation (SpO2 75%). (B) A more detailed view of the onset of apnea preceding EEG changes and EMG movement-related artifacts by 20 s. (A,B) Red arrows highlight the onset of the apnea. Note the ictal marked increase in heart rate. Red channel: ECG; blue channel: thoracoabdominal respirogram.
case_images: fneur-12-753860-g0001.jpg
case_images: PMC8599590_01_fneur-12-753860-g0001.jpg
case_images: F1
case_images: ICA for around 17 s before any other clinical manifestation (Figure 1).
case_images: PMC8599590_02
case_images: (A) Coronal FLAIR MRI of patient 2 (left) showing a hyperintense right amygdala with red arrow pointing to an area of increased signal intensity (red arrow). On the right, the FDG-PET image of the same patient showing right temporal hypometabolism involving the temporal pole and mesial regions. (B) Coronal FLAIR MRI of patient 4 (on the left) showing a temporo-mesial lesion that on T1 imaging (on the right) present a clear gadolinium enhancement suggesting a tumoral origin.
case_images: fneur-12-753860-g0002.jpg
case_images: PMC8599590_03_fneur-12-753860-g0002.jpg
case_images: F2
case_images: The 1.5 T MRI showed a right mesial temporal cortico-subcortical lesion (amygdala, temporal uncus, hippocampal head, and part of the hippocampal body) with gadolinium enhancement (Figure 2B).
case_images: PMC8599590_03
case_images: (A) Coronal FLAIR MRI of patient 2 (left) showing a hyperintense right amygdala with red arrow pointing to an area of increased signal intensity (red arrow). On the right, the FDG-PET image of the same patient showing right temporal hypometabolism involving the temporal pole and mesial regions. (B) Coronal FLAIR MRI of patient 4 (on the left) showing a temporo-mesial lesion that on T1 imaging (on the right) present a clear gadolinium enhancement suggesting a tumoral origin.
case_images: fneur-12-753860-g0002.jpg
case_images: PMC8599590_03_fneur-12-753860-g0002.jpg
case_images: F2
case_images: The 1.5 T MRI showed a right mesial temporal cortico-subcortical lesion (amygdala, temporal uncus, hippocampal head, and part of the hippocampal body) with gadolinium enhancement (Figure 2B).
case_images: (A) A 120-s view of a right temporal lobe seizure of patient 4. The apnea was the first ictal sign. The ictal EEG is characterized by a slow rhythmic theta activity on right temporal regions. (B) Apnea started 15 s before first EEG changes. (A,B) Red arrows point at the beginning of apnea on thoraco-abdominal polygraphic channel. Note the ictal marked increase in heart rate. Red channel: ECG; blue channel: respirogram.
case_images: fneur-12-753860-g0003.jpg
case_images: PMC8599590_03_fneur-12-753860-g0003.jpg
case_images: F3
case_images: We recorded four seizures arising from the right temporal regions during wakefulness, with occurrence of central apnea (lasting from 15 to 40 s) preceding the first EEG changes by 6-27 s (Figure 3).