Evidence that temporal lobe is a default area in absence epilepsy

Correctly classifying seizures is essential for appropriate epilepsy management. Focal and generalized epilepsy rarely occur independently in the same patient. Cases of focal ictal evolution during seizures that are generalized in onset have been reported though these have included a small heterogeneous series of patients with generalized epilepsy and features on the EEG. We wish to report two patients with absence epilepsy that were noted on video-EEG monitoring to manifest a focal temporal electroclinical transformation from a typical absence seizure. Defining the electroclinical spectrum of absence seizures could add to our understanding of the selective cortical and subcortical networks that are involved in patients with “prototypic” generalized and focal seizures.