This case further expands our understanding of the complexity of semiology in electroclinical classification and the spectrum that may occur in adult absence seizures. Instead of focal seizures, prolonged absence seizures were validated by video-EEG monitoring and she became seizure-free after a change to broad-spectrum antiepileptic drugs. We recently encountered a 53-year-old female with refractory seizures and a semiology strongly suggesting mesial temporal lobe epilepsy. However, the semiology of focal seizures associated with mesial temporal lobe epilepsy has a characteristic and consistent semiology that is the mark of this common epilepsy syndrome in adulthood. EEG can be especially misleading when secondary bilateral synchronous discharges occur in patients with focal seizures. Fortunately, a correct diagnosis of absence seizures is usually not difficult, though rarely demonstrates electroclinical overlap with focal seizures. Inappropriate medication choices occur in the treatment of generalized epilepsy and may aggravate some seizure types, including absence seizures, potentially leading to pseudo-drug resistance. Mots-clés : absence seizures, focal seizures, antiepileptic drugs, temporal lobe epilepsy, video-EEG monitoringĬorrect diagnosis of seizure type and epilepsy syndrome is the foundation for appropriate antiepileptic drug selection.1 Department of Neurology, Mayo Clinic, Jacksonville, FL
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