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Parietal Lobe Epilepsy
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Parietal Lobe Epilepsy

I am now 23 years of age and I have Parietal Lobe Epilepsy that is a result of a stroke I had when I was 9.  It affected my right parietal lobe.  I had no symptoms until age 18 when I had my first aura, which visual, the world looked scrambled.  I had a few more of these until I finally had a seizure that generalized into tonic clonic at age 20.  It also started with the visual misalignment as well as numbness in my left arm that spread into tonic movements throughout my whole body.  I was put on Keppra and controlled for two years on 750 mgs a day, and now I am not controlled.  Since November I have averaged one-two TCs a month that start as a partial but generalize, and they usually happen at night when I am falling asleep.  I am on 3000 mg of Keppra and 400 mg of zonegran, these seem to have stopped the tonics, but I still get the visuals, although they only last for a few seconds.  We captured a seizure on VEEG and it confirmed that the right parietal lobe was the focus.  Is there good reason to pursue surgery sooner rather than later?  My doctor said that they would not remove the entire lesion, but do the sub-dural grid and remove the area around the lesion that is causing the seizures; is that common and are the results good?  Is there reason to suspect that it would be a permanent fix?  If we removed a region on one side of the lesion that was causing seizures, what is to say that another region won't become active in causing seizures another five years later (this one waited about ten years as it was!)  Is there reason to suspect that the lesion is the root of this, or should I be getting tested for anything else to be sure that we are treating the cause and not the symptoms?
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Hi vanhalenfan,

How are you doing? Parietal lobe epilepsy is a relatively rare form of epilepsy, comprising about 5% of all epilepsy, in which seizures arise from the parietal lobe of the brain. Yes, your stroke is definitely the cause. Other causes may be the result of head trauma, birth difficulties, or tumor, though the cause is unknown in 20% of patients. The parietal lobe plays important roles in touch perception, the integration of sensory information and in visual perception of spatial relationships among objects. The parietal lobe is also involved with language, planned movements such as writing, as well as mathematical skills. This explains your earlier symptoms of visual misalignment and numbness in your hand. Treatment with antiepileptic medication is usually effective in controlling seizures in parietal lobe epilepsy. In severe cases, surgery may be an option. Your doctors have their best intention for you and I suggest you talk it over with them if you have any worries regarding this because they have the results of your presurgical evaluation. And they will explain to you so that you can decide for yourself with a clear picture of what will happen before, during or after the surgery.

There are several studies done about surgical outcomes of parietal lobe surgery. One such study is a study done in Korea in 2004, 40 people were diagnosed with parietal lobe epilepsy and where 22 of the 27 surgically treated patients had favorable outcome. 14 of these were seizure free after. Aside from the VEEG, MRI was also done wherein it correctly localized the lesion of 9 of the 14 who were seizure free after the operation. You can view this at this link: http://www.blackwell-synergy.com/doi/pdf/10.1111/j.0013-9580.2004.33703.x?cookieSet=1

I hope this helps. Take care always and regards.
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