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Cortical dysplasia mri

Eveline Teresa Hidalgo, Howard L Weiner
New developments in diagnostic methods, technical improvements in the surgical field, and a better understanding of the effects of epilepsy on the developing brain are contributing to the general observation that more children with epilepsy are being treated surgically. Malformations of cortical development are the most common cause of seizures in pediatric surgical candidates, and the best predictor of seizure freedom after surgery appears to be the complete removal of the epileptogenic lesion. To achieve this goal in challenging cases, such as magnetic resonance imaging-negative or multifocal lesions, a staged approach with pre- and/or post-resective invasive electroencephalography monitoring has increasingly been used at a number of centers...
October 11, 2016: Developmental Medicine and Child Neurology
Tally Lerman-Sagie, Zvi Leibovitz
Abnormal fetal corticogenesis results in malformations of cortical development (MCD). Abnormal cell proliferation leads to microcephaly or megalencephaly, incomplete neuronal migration results in heterotopia and lissencephaly, neuronal overmigration manifests as cobblestone malformations, and anomalous postmigrational cortical organization is responsible for polymicrogyria and focal cortical dysplasias. MCD comprises various congenital brain disorders, caused by different genetic, infectious, or vascular etiologies and is associated with significant neurological morbidity...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Muhammad T Khan, Roger Oghlakian, Mohamad Z Koubeissi
Determining the language-dominant hemisphere is essential for planning epilepsy surgery. A 60-year-old right-handed woman with epilepsy since age 16 failed a partial right anterior lobectomy at age 21. Later, a brain MRI found extensive right-sided cortical dysplasia and periventricular heterotopia. Subsequently, prolonged video-EEG monitoring localized her seizures to the right temporoparietal region. Functional MRI was inconclusive in lateralizing her language, prompting a Wada test, which strongly lateralized language to the right...
2016: Epilepsy & Behavior Case Reports
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
Eric Hohn, Nirav K Pandya
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents. QUESTIONS/PURPOSES: (1) Does allograft tissue in MPFL reconstruction in pediatric and adolescent patients restore patellar stability? (2) What complications were associated with allograft MPFL reconstructions in children and adolescents? METHODS: Between June 2012 and August 2015, one surgeon (NKP) performed 26 MPFL reconstructions in 23 patients with gracilis allograft for traumatic patellar instability...
September 2, 2016: Clinical Orthopaedics and related Research
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
Lakshminarayanan Kannan, Simon Vogrin, Catherine Bailey, Wirginia Maixner, A Simon Harvey
Multiple seizure foci, seizure propagation and epileptic spasms complicate presurgical seizure localization in tuberous sclerosis. Furthermore, controversy exists about the contribution of tubers, perituberal cortex and the underlying genetic abnormality to epileptogenesis. We aimed to determine the epileptogenic substrate in tuberous sclerosis by studying spatio-temporal patterns of seizure onset and propagation on intracranial EEG recordings in which multiple depth and surface electrodes sampled multiple tubers and perituberal cortex...
August 6, 2016: Brain: a Journal of Neurology
Ravindra Arya, James L Leach, Paul S Horn, Hansel M Greiner, Michael Gelfand, Anna W Byars, Todd M Arthur, Jeffrey R Tenney, Sejal V Jain, Leonid Rozhkov, Hisako Fujiwara, Douglas F Rose, Francesco T Mangano, Katherine D Holland
PURPOSE: Lack of a potentially epileptogenic lesion on brain magnetic resonance imaging (MRI) is a poor prognostic marker for epilepsy surgery. We present a single-center series of childhood-onset MRI-negative drug-resistant epilepsy (DRE) and analyze surgical outcomes and predictors. METHODS: Children with MRI-negative DRE who had resective surgery from January 2007 to December 2013 were identified using an institutional database. Relevant clinical, neurophysiological, imaging, and surgical data was extracted...
October 2016: Seizure: the Journal of the British Epilepsy Association
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
Chima Oluigbo, Matthew Sacino, John S Myseros, Suresh N Magge, William Gaillard, Robert F Keating
INTRODUCTION: Focal cortical dysplasia (FCD) is a common cause of intractable epilepsy in children. Seizure freedom following resection of FCD is determined by complete resection of the dysplastic cortical tissue. However, difficulty with intraoperative identification of the FCD lesion may limit the ability to achieve the surgical objective of complete extirpation of these lesions. The use of intraoperative magnetic resonance imaging (iMRI) may aid in real-time detection of these lesions and improve seizure control outcomes compared with traditional resective surgery...
August 2016: Neurosurgery
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
Guillaume Gras-Combe, Lorella Minotti, Dominique Hoffmann, Alexandre Krainik, Philippe Kahane, Stephan Chabardes
BACKGROUND: Hidden by the perisylvian operculi, insular cortex has long been underexplored in the context of epilepsy surgery. Recent studies advocated stereoelectroencephalography (SEEG) as a reliable tool to explore insular cortex and its involvement in intractable epilepsy and suggested that insular seizures could be an underestimated entity. However, the results of insular resection to treat pharmacoresistant epilepsy are rarely reported. OBJECTIVE: We report 6 consecutive cases of right insular resection performed based on anatomoelectroclinical correlations provided by SEEG...
October 2016: Neurosurgery
Lily C Wong-Kisiel, Jeffrey W Britton, Robert J Witte, Kristen M Kelly-Williams, Amy L Kotsenas, Karl N Krecke, Robert E Watson, Alice Patton, Dennis P Hanson, Jay Mandrekar
BACKGROUND: Focal cortical dysplasia is commonly recognized in pediatric epilepsy surgery. Despite characteristic radiographic features, focal cortical dysplasia can be subtle on magnetic resonance imaging. Double inversion recovery acquisition suppresses the white matter signal, which may enhance visualization of abnormal features at the gray-white matter interface. We assessed the ability of double inversion recovery to distinguish focal cortical dysplasia from periventricular nodular heterotopia and normal brain...
August 2016: Pediatric Neurology
Eser Lay Ergün, Serap Saygi, Dilek Yalnizoglu, Kader Karli Oguz, Belkis Erbas
In epilepsy, a detailed history, blood chemistry, routine electroencephalography, and brain MRI are important for the diagnosis of seizure type or epilepsy syndrome for the decision of appropriate drug treatment. Although antiepileptic drugs are mostly successful for controlling epileptic seizures, 20%-30% patients are resistant to medical treatment and continue to have seizures. In this intractable patient group, surgical resection is the primarily preferred treatment option. This particular group of patients should be referred to the epilepsy center for detailed investigation and further treatment...
July 2016: Seminars in Nuclear Medicine
Carolina Frassoni, Laura Avagliano, Francesca Inverardi, Luigina Spaccini, Cecilia Parazzini, Maria Angela Rustico, Gaetano Bulfamante, Andrea Righini
The development of the human cerebral cortex is a complex and precisely programmed process by which alterations may lead to morphological and functional neurological abnormalities. We report familial cases of prenatally diagnosed abnormal brain, characterized by aberrant symmetrical mesial oversulcation of the parietooccipital lobes, in fetuses affected by abnormal skeletal features. Fetal brain anomalies were characterized by prenatal magnetic resonance imaging at 21 weeks of gestation and histologically evaluated at 22 weeks...
August 2016: Neuropediatrics
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