{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:07:42Z","timestamp":1753891662458,"version":"3.41.2"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T00:00:00Z","timestamp":1720656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Netw. Physiol."],"abstract":"<jats:p>We present two cases with focal seizures where scalp electroencephalography (EEG) had prominent features of a developmental and epileptic encephalopathy (DEE): Case 1: a 17-year-old male with complex motor seizures whose EEG demonstrated a slow spike-and-wave pattern and generalized paroxysmal fast activity (GPFA). Case 2: a 12-year-old male with startle-induced asymmetric tonic seizures whose EEG also had a slow spike-and-wave pattern. Both patients had intracranial EEG assessment, and focal cortical resections resulted in long-term seizure freedom and resolution of generalized findings. These cases exemplify patients with focal epilepsy with networks that share similarities to generalized epilepsies, and importantly, these features did not preclude curative epilepsy surgery.<\/jats:p>","DOI":"10.3389\/fnetp.2024.1425329","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T04:27:35Z","timestamp":1720672055000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Focal, generalized, or both: does generalized network involvement preclude successful epilepsy surgery?"],"prefix":"10.3389","volume":"4","author":[{"given":"Cathy K.","family":"Cui","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wui-Kwan","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chong H.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Gill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W. K.","family":"Fong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,11]]},"reference":[{"key":"B2","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1093\/brain\/awh136","article-title":"fMRI activation during spike and wave discharges in idiopathic generalized epilepsy","volume":"127","author":"Aghakhani","year":"2004","journal-title":"Brain"},{"key":"B3","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1001\/jamaneurol.2018.4316","article-title":"Association of seizure spread with surgical failure in epilepsy","volume":"76","author":"Andrews","year":"2019","journal-title":"JAMA Neurol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"225","DOI":"10.3389\/fneur.2014.00225","article-title":"Conceptualizing lennox-gastaut syndrome as a secondary network epilepsy","volume":"5","author":"Archer","year":"2014","journal-title":"Front. Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1111\/epi.13791","article-title":"Defining epileptogenic networks: contribution of SEEG and signal analysis","volume":"58","author":"Bartolomei","year":"2017","journal-title":"Epilepsia"},{"key":"B1","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/0013-4694(74)90031-5","article-title":"\u201cGeneralized\u201d epileptic seizures elicited by electrical stimulation of the frontal lobe in man","volume":"37","author":"Bancaud","year":"1974","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1093\/brain\/awp028","article-title":"Cortical and subcortical networks in human secondarily generalized tonic-clonic seizures","volume":"132","author":"Blumenfeld","year":"2009","journal-title":"Brain"},{"key":"B7","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.yebeh.2013.12.003","article-title":"Emergence of semiology in epileptic seizures","volume":"38","author":"Chauvel","year":"2014","journal-title":"Epilepsy Behav."},{"key":"B8","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1007\/s10548-016-0493-3","article-title":"Identification of focal epileptogenic networks in generalized epilepsy using brain functional connectivity analysis of bilateral intracranial EEG signals","volume":"29","author":"Chen","year":"2016","journal-title":"Brain Topogr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1007\/s00415-017-8535-7","article-title":"Understanding Lennox-Gastaut syndrome: insights from focal epilepsy patients with Lennox-Gastaut features","volume":"264","author":"Dupont","year":"2017","journal-title":"J. Neurol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1136\/jnnp.2007.116038","article-title":"Factors influencing surgical outcome in patients with focal cortical dysplasia","volume":"79","author":"Fauser","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1111\/j.1528-1167.2011.03172.x","article-title":"Functional neuroimaging in startle epilepsy: involvement of a mesial frontoparietal network","volume":"52","author":"Fernandez","year":"2011","journal-title":"Epilepsia"},{"key":"B12","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.neuroimage.2007.07.009","article-title":"BOLD and perfusion changes during epileptic generalised spike wave activity","volume":"39","author":"Hamandi","year":"2008","journal-title":"Neuroimage"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1212\/wnl.54.7.1470","article-title":"EEG predicts surgical outcome in lesional frontal lobe epilepsy","volume":"54","author":"Janszky","year":"2000","journal-title":"Neurology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1756","DOI":"10.1111\/epi.17960","article-title":"Edge-wise analysis reveals white matter connectivity associated with focal to bilateral tonic-clonic seizures","volume":"65","author":"Javidi","year":"2024","journal-title":"Epilepsia"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e85","DOI":"10.1111\/epi.12659","article-title":"The pivotal role of the supplementary motor area in startle epilepsy as demonstrated by SEEG epileptogenicity maps","volume":"55","author":"Job","year":"2014","journal-title":"Epilepsia"},{"key":"B16","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.yebeh.2010.10.025","article-title":"Generalized 3-Hz spike-and-wave complexes emanating from focal epileptic activity in pediatric patients","volume":"20","author":"Kakisaka","year":"2011","journal-title":"Epilepsy Behav."},{"key":"B17","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1684\/epd.2014.0672","article-title":"Focal epilepsy recruiting a generalised network of juvenile myoclonic epilepsy: a case report","volume":"16","author":"Khaing","year":"2014","journal-title":"Epileptic Disord."},{"key":"B18","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1002\/ana.21398","article-title":"Different features of histopathological subtypes of pediatric focal cortical dysplasia","volume":"63","author":"Krsek","year":"2008","journal-title":"Ann. Neurol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1007\/s10548-018-0649-4","article-title":"Increased functional MEG connectivity as a hallmark of MRI-negative focal and generalized epilepsy","volume":"31","author":"Li","year":"2018","journal-title":"Brain Topogr."},{"key":"B20","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1684\/j.1950-6945.2006.tb00204.x","article-title":"The epileptogenic zone: general principles","volume":"8","author":"Luders","year":"2006","journal-title":"Epileptic Disord."},{"key":"B21","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1097\/00004691-200311000-00005","article-title":"Lennox-Gastaut syndrome (childhood epileptic encephalopathy)","volume":"20","author":"Markand","year":"2003","journal-title":"J. Clin. Neurophysiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.1111\/epi.16994","article-title":"On seizure semiology","volume":"62","author":"McGonigal","year":"2021","journal-title":"Epilepsia"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1523\/JNEUROSCI.22-04-01480.2002","article-title":"Cortical focus drives widespread corticothalamic networks during spontaneous absence seizures in rats","volume":"22","author":"Meeren","year":"2002","journal-title":"J. Neurosci."},{"key":"B24","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.braindev.2014.03.006","article-title":"Asymmetrical generalized paroxysmal fast activities in children with intractable localization-related epilepsy","volume":"37","author":"Mohammadi","year":"2015","journal-title":"Brain Dev."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e2211","DOI":"10.1212\/WNL.0000000000200145","article-title":"Association between semiology and anatomo-functional localization in patients with cingulate epilepsy: a cohort study","volume":"98","author":"Pelliccia","year":"2022","journal-title":"Neurology"},{"key":"B26","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1212\/WNL.0b013e3182a08f6a","article-title":"Networks underlying paroxysmal fast activity and slow spike and wave in Lennox-Gastaut syndrome","volume":"81","author":"Pillay","year":"2013","journal-title":"Neurology"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1136\/jnnp-2011-301944","article-title":"Large scale brain models of epilepsy: dynamics meets connectomics","volume":"83","author":"Richardson","year":"2012","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"B28","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1046\/j.1528-1157.2002.26901.x","article-title":"Neural networks in human epilepsy: evidence of and implications for treatment","volume":"43","author":"Spencer","year":"2002","journal-title":"Epilepsia"},{"key":"B29","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/0013-4694(52)90079-5","article-title":"The electroencephalogram in parasagittal lesions","volume":"4","author":"Tukel","year":"1952","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"7043","DOI":"10.1038\/s41598-020-63430-9","article-title":"Dynamic network properties of the interictal brain determine whether seizures appear focal or generalised","volume":"10","author":"Woldman","year":"2020","journal-title":"Sci. Rep."}],"container-title":["Frontiers in Network Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnetp.2024.1425329\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T04:27:38Z","timestamp":1720672058000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnetp.2024.1425329\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,11]]},"references-count":30,"alternative-id":["10.3389\/fnetp.2024.1425329"],"URL":"https:\/\/doi.org\/10.3389\/fnetp.2024.1425329","relation":{},"ISSN":["2674-0109"],"issn-type":[{"type":"electronic","value":"2674-0109"}],"subject":[],"published":{"date-parts":[[2024,7,11]]},"article-number":"1425329"}}