Surgical resection of focal cortical dysplasias in the central region

Neuro-Chirurgie
D MarnetCatherine Daumas-Duport

Abstract

Taylor-type focal cortical dysplasias (TTFCD) represent a particular pathological entity responsible for severe drug-resistant epilepsy of extratemporal location. Epilepsy can be surgically cured if complete removal of the lesion can be performed. However, identification on imaging may be difficult and negative standard MRIs are not rare. The frequent location of TTFCD in the central region restrains the possibilities of complete resection. We report a series of patients operated on for intractable epilepsy associated with TTFCD in the central area. Between 2000 and 2006, of 34 consecutive patients with TTFCD, 17 had a lesion located in the central area. MRI was considered normal in eight, although in five a subtle gyral abnormality was disclosed on further analysis. A (18)FDG PET scan performed in 16 cases demonstrated focal hypometabolism in 15 that correlated with abnormalities on MRI when visible. SEEG performed in 13 cases revealed typical abnormalities for TTFCD in 10 cases. At resection, cortical and subcortical stimulations of the dysplastic cortex did not elicit a motor response. Postoperative motor or sensory deficit was observed in 13 patients--severe in four--which subsequently resolved completely in seven. Six pati...Continue Reading

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Jun 12, 2014·Acta Neuropathologica·Imad M NajmGiorgio Lo Russo
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Nov 29, 2015·Neurosurgery Clinics of North America·Soha AlomarJorge Gonzalez-Martinez
Jun 2, 2020·Neurosurgery Clinics of North America·Jorge Alvaro Gonzalez-Martinez, Patrick Chauvel

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