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¹“Carol Davila” University of Medicine Bucharest, Department of Neurology, Pediatric Neurology, Psychiatry, Neurosurgery Discipline, Bucharest, Romania
²“Alexandru Obregia” Clinical Psychiatric Hospital, Pediatric Neurology Clinic, Şos. Berceni 10- 12, Sector 4, Bucharest, Romania
³University of Bucharest, Physics Department, Bucharest, Romania
⁴FHC Inc, Bowdoin ME, USA
⁵Bagdasar Arseni Emergency Hospital, Functional Neurosurgery Department, Şos. Berceni 14-16, Sector 4, Bucharest, Romania
⁶University Emergency Hospital Bucharest, Neurology Clinic, Str. Splaiul Independenţei Nr 169, Sector 5, Bucharest, Romania DOI : 10.5137/1019-5149.JTN.12093-14.0 Magnetic resonance imaging (MRI)-negative epilepsy may be successfully solved with a multidisciplinary approach using invasive recordings, image and signal analysis. The whole methodology used by the epilepsy surgery team is systematically described based on an resistant epilepsy case with all steps and rationale of choosing different investigation methods from surface electroencephalography (EEG) to invasive recordings. Due to negative MRI and non-concordant ictal surface EEG with clinical semiology, the patient was investigated with stereo- EEG (SEEG), aiming to delimitate epileptogenic and eloquent cerebral areas. Implantation strategy, seizures recordings, stimulation, resection planning using quantitative EEG analysis, and the surgery plan are presented. The patient has been seizure-free for 14 months so far, with improved behavior and daily life quality. Post-operative examination revealed focal cortical dysplasia type II B. Keywords : Epilepsy surgery, Focal cortical dysplasia, MRI-negative postsurgical outcome, Resistant epilepsy, Stereo-EEG