We describe a patient with medically refractory focal epilepsy who presented with divergent non-invasive data, with MRI revealing hippocampal sclerosis and EEG indicating involvement of the occipital lobe. A localized corticectomy over the occipital convexity was performed based on intracranial EEG recording. The patient was seizure-free after four years of follow-up. Electroclinical hypotheses and challenges of defining the epileptogenic network are discussed.
Keywords: atypical epileptogenic network; epilepsy surgery; hippocampal sclerosis; intractable epilepsy; occipital resection.