Background: Idiopathic generalized epilepsy (IGE) is a heterogeneous condition with a predominantly genetic origin. Clinical hallmarks of IGE syndromes include generalized spike and wave discharges and normal results on brain imaging.
Objective: To describe 2 patients with clinical presentations compatible with IGE but whose imaging studies revealed unilateral thalamic lesions.
Design: Case reports.
Setting: University-affiliated hospitals.
Patients: Two 21-year-old patients (1 man and 1 woman).
Main outcome measures: Magnetic resonance imaging findings.
Results: Magnetic resonance imaging unexpectedly revealed unilateral thalamic lesions.
Conclusions: We recommend doing magnetic resonance imaging studies in patients with IGE, especially in refractory or atypical cases. In rare cases, clinical features compatible with IGE may be associated with structural thalamic or other lesions.