Neocortical Epilepsies - Do They Progress?

Recruitment & Eligibility

Inclusion Criteria

Ages 18-65, based on the usual ages of patients seen in the adult neurology services who are not likely to suffer from the exclusions (see below), plus
History of myoclonic plus tonic-clonic or clonic-tonic-clonic seizures with or without absence seizures.
EEG consistent with primary generalized epilepsy (>/= 3 c/s generalized, frontal maximum, poly spike and wave; normal alpha)

Exclusion Criteria

History of significant head injury (> 30 min loss of consciousness)
Use of neuroleptic drugs or sedative doses of antianxiety or antidepressant drugs
History of any substance abuse within the past 5 years
Presence of epileptogenic brain lesion on MRI (tumor, stroke, cortical congenital dysplasia, etc; excluding normal variants, mild subcortical white matter ischemic change, venous angiomas).
EEG with focal epileptiform potentials or polymorphic slowing
History of progressive medical or neurologic disease (Parkinson's, severe congestive heart failure). Controlled hypertension, diabetes (by oral medications or diet), asthma, etc will not be excluded.
History of stroke without complete recovery of neurologic function.
Pregnancy
With any metallic implants, including surgical clips (hemostatic clips), pacemakers, neuro-stimulation devices, prosthetic heart valves, or other ferromagnetic material.
Inability to speak fluent English

Frontal Lobe Epilepsy (FLE; 20 Subjects):

Inclusion Criteria

Ages 18-65, based on the usual ages of patients seen in the adult neurology services who are not likely to suffer from the exclusions (see below), plus:
Seizure semiology (behavior) consistent with FLE
Interictal EEG spikes consistent with FLE or
Ictal video-EEG consistent with FLE
Frontal lobe lesion of MRI
Frontal hypometabolism on FDG-PET

Exclusion Criteria

Presence of seizure semiology, ictal EEG, interictal EEG, MRI or PET findings that are not consistent with a frontal lobe epilepsy focus.
Use of neuroleptic drugs or sedative doses of antianxiety or antidepressant drugs
History of any substance abuse within the past 5 years
History of progressive medical or neurologic disease (Parkinson's, severe congestive heart failure). Controlled hypertension, diabetes (by oral medications or diet), asthma, etc will not be excluded.
History of stroke without complete recovery of neurologic function.
Pregnancy
With any metallic implants, including surgical clips (hemostatic clips), pacemakers, neuro-stimulation devices, prosthetic heart valves, or other ferromagnetic material.
Absence of either a radial or ulnar arterial pulse
Inability to speak fluent English

Primary Outcome Measures

Name	Time	Method
Functional Connectivity	During Imaging Session	We will analyze the structural and metabolic differences between two epilepsy groups (JME and FLE) and understand the imaging presentations of epilepsy patients. We will process imaging requisition for Arm 1 and Arm 2 patients and the controls to examine if any differences in their brain image. The hypothesis is the functional connectivity between brainstem structures and cortical/subcortical regions may reflect in their imaging data. We would like to know if these imaging factors are related to epilepsy (JME and FLE) patients.

Secondary Outcome Measures