Propagation of Focal Epilepsies and the Timing and Targeting of Surgical Interventions. Illustrative Case Reports

The mirror focus conception assumes propagation of epileptic excitation towards a homotopic area of the contralateral hemisphere inducing secondary focal discharges. Later, independent discharges can be initiated by this new area of epileptogenesis but initiation of seizures of the same or altered symptomatology—and not only in- terictal discharges—from a mirror focus has yet not been proved. Three cases will be presented where dynamism of the development of temporal lobe mirror focus have been followed. All cases give rise to several questions concerning selection and timing of surgical approach.