Dense array EEG estimated the epileptic focus in a patient with epilepsy secondary to tuberous sclerosis complex

Tuberous sclerosis complex (TSC) is a leading cause of epilepsy, with seizures affecting almost 80–90% of children. We used the concordance between magnetic resonance imaging (MRI) and dense array electroencephalography (dEEG) findings to detect epileptic focus in a patient with TSC. A 9-year-old boy with TSC exhibited daily choking spells. As we could not detect the seizure onset area with conventional scalp electroencephalogram (EEG) and long-term video monitoring, we performed dEEG and captured his regular seizures. dEEG estimated that the clinical seizure activities from the right frontal region. This patient underwent focus removal, tuberectomy of the right frontal lobe, and removal of a subependymal giant cell astrocytoma. He has been seizure free for 7 years and 10 months. dEEG was useful for estimation of the placement of intracranial electrodes in a patient with TSC. This method may be useful for pre-surgical evaluation of epilepsy treatment.