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MRI focal cortical dysplasia

Masaki Iwasaki, Kazutaka Jin, Nobukazu Nakasato, Teiji Tominaga
Epilepsy surgery is aimed to remove the brain tissues that are indispensable for generating patient's epileptic seizures. There are two purposes in the pre-operative evaluation: localization of the epileptogenic zone and localization of function. Surgery is planned to remove possible epileptogenic zone while preserving functional area. Since no single diagnostic modality is superior to others in identifying and localizing the epileptogenic zone, multiple non-invasive evaluations are performed to estimate the location of the epileptogenic zone after concordance between evaluations...
October 15, 2016: Neurologia Medico-chirurgica
Maura E Ryan
Investigators from the Mayo Clinic, Rochester Minnesota investigated the utility of three-dimensional (3D) double inversion recovery (DIR) sequences in magnetic resonance imaging (MRI) detection of focal cortical dysplasia (FCD) in children and young adults with epilepsy.
April 2016: Pediatric neurology briefs
Jonathan M DuBois, Olivier G Rousset, Marie-Christine Guiot, Jeffery A Hall, Andrew J Reader, Jean-Paul Soucy, Pedro Rosa-Neto, Eliane Kobayashi
Metabotropic glutamate receptor type 5 (mGluR5) abnormalities have been described in tissue resected from epilepsy patients with focal cortical dysplasia (FCD). To determine if these abnormalities could be identified in vivo, we investigated mGluR5 availability in 10 patients with focal epilepsy and an MRI diagnosis of FCD using positron-emission tomography (PET) and the radioligand [(11)C]ABP688. Partial volume corrected [(11)C]ABP688 binding potentials (BPND) were computed using the cerebellum as a reference region...
August 30, 2016: Cerebral Cortex
B Schmeiser, T Hammen, B J Steinhoff, J Zentner, A Schulze-Bonhage
OBJECT: The intention of our study was to identify predictive characteristics for long-term seizure control and running down phenomenon after surgical treatment of pharmacoresistant mesiotemporal lobe epilepsy (mTLE) with and without associated cortical dysplasia. MATERIALS AND METHODS: Our study comprises a consecutive series of 458 patients who underwent surgical treatment for intractable mTLE at the Epilepsy Center Freiburg. Data evaluated included semiology, duration and frequency of seizures, results of presurgical diagnostics including video-EEG monitoring, MRI, PET and SPECT as well as postoperative seizure outcome...
October 2016: Epilepsy Research
Tim J Veersema, Pieter van Eijsden, Peter H Gosselaar, Jeroen Hendrikse, Jaco J M Zwanenburg, Wim G M Spliet, Eleonora Aronica, Kees P J Braun, Cyrille H Ferrier
Focal cortical dysplasia is one of the most common underlying pathologies in patients who undergo surgery for refractory epilepsy. Absence of a MRI-visible lesion necessitates additional diagnostic tests and is a predictor of poor surgical outcome. We describe a series of six patients with refractory epilepsy due to histopathologically-confirmed focal cortical dysplasia, for whom pre-surgical 7 tesla T2*-weighted MRI was acquired. In four of six patients, T2* sequences showed areas of marked superficial hypointensity, co-localizing with the epileptogenic lesion...
September 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
Rita Garbelli, Roberto Spreafico, Andrea Barbaglia, Laura Rossini, Gloria Milesi, Ileana Zucca, Massimo Cossu, Manuela Bramerio, Laura Tassi
No abstract text is available yet for this article.
October 2016: Seizure: the Journal of the British Epilepsy Association
A J Colon, M J P van Osch, M Buijs, J V D Grond, P Boon, M A van Buchem, P A M Hofman
In 11 adult patients with suspicion of Focal cortical dysplasia (FCD) on 1.5 T (n = 1) or 3 T (n = 10) magnetic resonance imaging (MRI), 7 T MRI was performed. Visibility, extent, morphological features and delineation were independently rated and subsequently discussed by three observers. Additionally, head-to-head comparisons with corresponding 3 T images were made in the eight patients with a previous 3 T MRI and sustained suspicion of FCD. Comparison with histopathology was done in the five patients that underwent surgery...
September 2016: Acta Neurologica Belgica
Angelo Russo, Matt Lallas, Prasanna Jayakar, Ian Miller, Ann Hyslop, Catalina Dunoyer, Trevor Resnick, Michael Duchowny
OBJECTIVE: This study investigates whether a combined rotating dipole (RD) and moving dipole (MD) solution enhances three-dimensional electroencephalography (EEG) source imaging (3D-ESI) localization in magnetic resonance imaging (MRI)-negative pediatric patients with focal cortical dysplasia (FCD). METHODS: We retrospectively selected 14 MRI-negative patients with FCD from a cohort of 60 pediatric patients previously used to evaluate the diagnostic utility of 3D-ESI in epilepsy surgery...
September 2016: Epilepsia
Jörg Wellmer, Jürgen Voges, Yaroslav Parpaley
Lesion guided radiofrequency thermocoagulation (L-RFTC) via stereotactically inserted coagulation probes is a further development of stereotactic thermocoagulation thalamotomy and stereo-EEG guided RFTC. In this method epileptogenic lesions detected via magnetic resonance imaging (MRI) move to the center of coagulation planning. Two surgical strategies can be applied: lesion disconnection and lesion destruction. This focused review collects all data published until January 2016 on L-RFTC for the indications hypothalamic hamartoma, periventricular nodular heterotopia and focal cortical dysplasia and describes technical issues, surgical objectives and outcomes...
October 2016: Seizure: the Journal of the British Epilepsy Association
Midori Nakajima, Elysa Widjaja, Shiro Baba, Yosuke Sato, Ryuhei Yoshida, Maya Tabei, Ayaka Okazaki, Satoru Sakuma, Stephanie A Holowka, Ayako Ochi, O Carter Snead, James T Rutka, James M Drake, Hideaki Shiraishi, Sam Doesburg, Hiroshi Otsubo
OBJECTIVE: To investigate whether the magnetoencephalography (MEG) single moving dipole (SMD) method could delineate the epileptic zone of focal cortical dysplasia (FCD) at the bottom of sulcus (FCDB). METHODS: We retrospectively analyzed 17 children (11 male; mean age 8.8 years, range 3-17 years) with FCD type II who underwent epilepsy surgery. We compared spatial congruence between the following: (1) MEG cluster and FCDB and (2) MEG cluster and FCD at the brain surface (FCDS)...
July 2016: Epilepsia
Ashalatha Radhakrishnan, Ramshekhar Menon, Deepak Menon, Atampreet Singh, Neelima Radhakrishnan, George Vilanilam, Mathew Abraham, Bejoy Thomas, Chandrashekharan Kesavadas, Ravi Prasad Varma, Sanjeev V Thomas
PURPOSE: We analyzed consecutive cases of a large cohort of the spectrum of malformations of cortical development (MCDs) including focal cortical dysplasias (FCDs) who underwent presurgical evaluation through our epilepsy program from January 2000-December 2010. We analyzed factors predicting surgical candidacy, predictors of seizure outcome and reasons for deferring surgery. METHODS: 148 patients with MCD underwent detailed presurgical evaluation and 69 were operated...
August 2016: Epilepsy Research
Stephanie Gollwitzer, Ivan Valente, Roman Rodionov, Catherine Scott, Laura Mantoan Ritter, Tim Wehner, Hajo M Hamer, Fabrice Bartolomei, Beate Diehl
INTRODUCTION: The aim of the study was the evaluation of the added value of depth to subdural electrodes in delineating epileptogenicity of focal cortical dysplasias (FCDs) and to test the Epileptogenicity Index (EI) in this setting. MATERIAL AND METHODS: Fifteen patients with FCD underwent iEEG with subdural and depth electrodes. Visual/EI analysis was performed in up to three habitual seizures per patient. RESULTS: Visual analysis: Grid onset seizures (n=10) started in electrodes overlying the lesion in 7 and remote from it in 3 cases...
May 2016: Epilepsy & Behavior: E&B
Naotaka Usui
This article reviews the current topics in the field of epilepsy surgery. Each type of epilepsy is associated with a different set of questions and goals. In mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS), postoperative seizure outcome is satisfactory. A recent meta-analysis revealed superior seizure outcome after anterior temporal lobectomy compared with selective amygdalohippocampectomy; in terms of cognitive outcome; however, amygdalohippocampectomy may be beneficial. In temporal lobe epilepsy with normal magnetic resonance imaging (MRI), postoperative seizure outcome is not as favorable as it is in MTLE with HS; further improvement of seizure outcome in these cases is necessary...
May 15, 2016: Neurologia Medico-chirurgica
V S Khalilov, A A Kholin, N A Medvedeva, I G Vasiliev, I V Rasskazchikova, R R Ismailova, A N Kislyakov, A A Demushkina, A A Alikhanov
OBJECTIVE: To analyze MR-images in patients with symptomatic epilepsy associated with the brain tumor. MATERIAL AND METHODS: MRI results of 52 patients with symptomatic epilepsy operated for tumors of supratentorial localization were analyzed. The most epileptogenic tumors with atypical MRI signs and subtle clinical presentation were identified. All patients with tumors were operated using different methods of surgical intervention. RESULTS: Dysembryoplastic neuroepithelial tumors (DNET), diffuse astrocytomas (DA) and gangliogliomas (GG) were the most frequent epileptogenic tumors...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Matthew F Sacino, Cheng-Ying Ho, Jonathan Murnick, Robert F Keating, William D Gaillard, Chima O Oluigbo
OBJECTIVE: Previous studies have demonstrated that an important factor in seizure freedom following surgery for lesional epilepsy in the peri-eloquent cortex is completeness of resection. However, aggressive resection of epileptic tissue localized to this region must be balanced with the competing objective of retaining postoperative neurological functioning. The objective of this study was to investigate the role of intraoperative MRI (iMRI) as a complement to existing epilepsy protocol techniques and to compare rates of seizure freedom and neurological deficit in pediatric patients undergoing resection of perieloquent lesions...
March 2016: Neurosurgical Focus
Karl Roessler, Andrea Hofmann, Bjoern Sommer, Peter Grummich, Roland Coras, Burkard Sebastian Kasper, Hajo M Hamer, Ingmar Blumcke, Hermann Stefan, Christopher Nimsky, Michael Buchfelder
OBJECTIVE: Intraoperative overestimation of resection volume in epilepsy surgery is a well-known problem that can lead to an unfavorable seizure outcome. Intraoperative MRI (iMRI) combined with neuronavigation may help surgeons avoid this pitfall and facilitate visualization and targeting of sometimes ill-defined heterogeneous lesions or epileptogenic zones and may increase the number of complete resections and improve seizure outcome. METHODS: To investigate this hypothesis, the authors conducted a retrospective clinical study of consecutive surgical procedures performed during a 10-year period for epilepsy in which they used neuronavigation combined with iMRI and functional imaging (functional MRI for speech and motor areas; diffusion tensor imaging for pyramidal, speech, and visual tracts; and magnetoencephalography and electrocorticography for spike detection)...
March 2016: Neurosurgical Focus
Matthew F Sacino, Cheng-Ying Ho, Jonathan Murnick, Tammy Tsuchida, Suresh N Magge, Robert F Keating, William D Gaillard, Chima O Oluigbo
OBJECTIVE Previous meta-analysis has demonstrated that the most important factor in seizure freedom following surgery for focal cortical dysplasia (FCD) is completeness of resection. However, intraoperative detection of epileptogenic dysplastic cortical tissue remains a challenge, potentially leading to a partial resection and the need for reoperation. The objective of this study was to determine the role of intraoperative MRI (iMRI) in the intraoperative detection and localization of FCD as well as its impact on surgical decision making, completeness of resection, and seizure control outcomes...
June 2016: Journal of Neurosurgery. Pediatrics
Richard A Prayson, Elizabeth E O'Toole
Cavernous angiomas or cavernomas have been occasionally described in patients presenting with medically intractable epilepsy. Reports of cavernomas associated with a second pathology potentially causative of seizures have rarely been documented; most commonly, the second pathology is focal cortical dysplasia or less frequently, hippocampal sclerosis. To our knowledge, cases of arteriovenous malformation arising in this clinical setting and associated with hippocampal sclerosis have not been previously described...
June 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Sangeeta Ravat, Vivek Iyer, Keyurkumar Panchal, Dattatraya Muzumdar, Abhijit Kulkarni
INTRODUCTION: The Comprehensive Epilepsy Surgery Program was started in 2001 at K.E.M. Hospital, Mumbai with the aim of performing epilepsy surgeries at highly concessional rates. We have started using intraoperative Electrocorticography (EcoG) since 2009 in patients with tumors, Mesial Temporal Sclerosis (MTS) plus and focal cortical dysplasia (FCD). This study highlights our experience with EcoG and it's utility in epilepsy surgery.introduction METHODS: 51 patients with drug resistant epilepsy due to temporal and extra-temporal tumors, MTS plus and FCD underwent pre-surgical evaluation and ECoG guided epilepsy surgery through our program...
February 15, 2016: International Journal of Surgery
Philippe Ryvlin, Sylvain Rheims
PURPOSE OF REVIEW: This review summarizes recent evidence on the seizure, safety, cognitive and psychosocial outcomes of epilepsy surgery and their predictors. RECENT FINDINGS: Risks of serious surgical complications have dramatically decreased over years to drop below 1% for temporal lobe resections. Although chances of postoperative seizure freedom largely vary between recent series, some data suggest that long-term seizure control might be achieved in over 80% of patients with mesial temporal lobe epilepsy or neocortical epilepsy associated with type 2 focal cortical dysplasia, and in up to two-thirds of patients with extratemporal lobe epilepsy...
April 2016: Current Opinion in Neurology
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