Generalized spike-wave discharges with focal onset in a patient with head trauma and diffuse cerebral lesions: A case report with EEG and cranial MRI findings

The role of cerebral lesions associated with absence seizures, outside the frontal lobe, has not been demonstrated by both electroencephalography and neuroimaging techniques until now, to our knowledge. We present a case with absence seizures and EEGs with generalized 3 Hz spike-wave patterns that were preceded by a burst of spike-waves on the right parieto-occipital region. The patient had a history of head trauma, and cranial MRI revealed lesions that might be responsible for the seizures. The patient's lateralized and localized EEG findings were probably a representation of secondary bilateral synchrony (SBS). The mechanism of SBS is considerably more complex than a simple triggering of generalized spike-wave complexes from a single cortical focus.