Frontal origin in a child with Panayiotopoulos syndrome (MEG)

The patient had seizures typical of Panayiotopoulos syndrome from the age of 4 years. EEGs initially showed occipital spikes, but at the age of 13, EEG had bifrontal spikes and MEG was performed. The patient’s younger brother also had Panayiotopoulos syndrome preceded by febrile seizures and followed by rolandic seizures. (A) MEG wave forms. The reversed colored MEG wave forms, in white in the vertical dark zone, were analyzed. (B) Magnetic source images revealed clustering equivalent current dipoles of spike discharges alongside the right inferior frontal sulcus, but the orientations were not so regular. All MRIs are T1-weighted. The pale-colored solid circles and tails represent the locations and orientations of equivalent current dipoles of the spike discharges. The early somatosensory evoked field was modeled using a single equivalent current dipole approach to estimate the spatial source of response, whereas the dark-colored solid circles and tails indicated by red arrows represent the locations and orientations of somatosensory evoked fields (N20). (Reproduced with permission from: Saitoh N, Kanazawa O, Toyama J, Akasaka N, Kamimura T. Magnetoencephalographic findings of Panayiotopoulos syndrome with frontal epileptic discharges. Pediatr Neurol 2007;36:190-4.)