Dense array EEG estimated the epileptic focus in a patient with epilepsy secondary to tuberous sclerosis complex

Purpose: Tuberous sclerosis complex (TSC) is a leading cause of epilepsy, with seizures affecting almost 80-90% of children. We used the concordance between magnetic resonance imaging (MRI) and dense array electroencephalography (dEEG) findings to detect epileptic focus in a patient with TSC. Methods: A 9-year-old boy with TSC exhibited daily choking spells. As we could not detect the seizure onset area with conventional scalp electroencephalogram (EEG) and long-term video monitoring, we performed dEEG and captured his regular seizures. Results: dEEG estimated that the clinical seizure activities from the right frontal region. This patient underwent focus removal, tuberectomy of the right frontal lobe, and removal of a subependymal giant cell astrocytoma. He has been seizure free for 7 years and 10 months. Conclusion: dEEG was useful for estimation of the placement of intracranial electrodes in a patient with TSC. This method may be useful for pre-surgical evaluation of epilepsy treatment. (C) 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.