A patient with chronic cerebral paragonimiasis began to have new motor seizures of the right face clonic contractions that occurred several hundred times a day resulting in the simple partial status epilepticus. The ictal EEG discharge started from the left frontal region and then spread to the left hemisphere. The ictal discharges were limited clearly to the left hemisphere. The brain MRI showed the multiple conglomerated round nodules with encephalomalacia in the left temporo-occipital lobes. Applying the ictal-interictal subtracted SPECT, we were able to localize the focal ictal hyperperfusion on the left precentral cortex adjacent to the lesions that correspond to the anatomical distribution of the left face motor area.
Brain ; Electroencephalography ; Encephalomalacia ; Epilepsies, Partial ; Humans ; Magnetic Resonance Imaging ; Paragonimiasis* ; Seizures ; Status Epilepticus* ; Subtraction Technique ; Tomography, Emission-Computed, Single-Photon*