Value of ultralong-term subcutaneous EEG monitoring for treatment decisions in temporal lobe epilepsy: A case report

Treatment decisions in epilepsy critically depend on information on the course of the disease, its severity and options for specific local interventions. We here report a patient with pharmaco-resistant non-lesional temporal lobe epilepsy with evidence for predominant right temporal epileptogenesis. While seizure frequency had been grossly underestimated for many years, ultralong-term monitoring with a subcutaneous EEG device revealed actual seizure frequency (66 over 11 months vs four patient-documented seizures), providing objective data on treatment efficacy and additional supportive lateralizing information that played a decisive role for the choice of surgical treatment, which had been rejected by the patient prior to this information.

Automated summary

Treatment decisions in epilepsy depend on information about disease progression, severity and specific local interventions. A patient with pharmaco-resistant non-lesional temporal lobe epilepsy is reported here, where long-term monitoring with a subcutaneous EEG device revealed a much higher seizure frequency than estimated before. This provided objective data on treatment efficacy and played a decisive role in the choice of surgical treatment.