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. 2012:2012:736784.
doi: 10.1155/2012/736784. Epub 2012 Mar 5.

Noninvasive approach to focal cortical dysplasias: clinical, EEG, and neuroimaging features

Gustavo Seifer  1 , Alejandro Blenkmann, Juan Pablo Princich, Damián Consalvo, Cristina Papayannis, Carlos Muravchik, Silvia Kochen
Affiliations

Noninvasive approach to focal cortical dysplasias: clinical, EEG, and neuroimaging features

Gustavo Seifer et al. Epilepsy Res Treat. 2012.

Abstract

Purpose. The main purpose is to define more accurately the epileptogenic zone (EZ) with noninvasive methods in those patients with MRI diagnosis of focal cortical dysplasia (FCD) and epilepsy who are candidates of epilepsy surgery. Methods. Twenty patients were evaluated prospectively between 2007 and 2010 with comprehensive clinical evaluation, video-electroencephalography, diffusion tensor imaging (DTI), and high-resolution EEG to localize the equivalent current dipole (ECD). Key Findings. In 11 cases with white matter asymmetries in DTI the ECDs were located next to lesion on MRI with mean distance of 14.63 millimeters with topographical correlation with the EZ. Significance. We could establish a hypothesis of EZ based on Video-EEG, high-resolution EEG, ECD method, MRI, and DTI. These results are consistent with the hypothesis that the EZ in the FCD is complex and is often larger than visible lesion in MRI.

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Figures

Figure 1
Figure 1
(a) 3D plot of electrodes and fiducial locations in a 3D virtual space in 3D electrode acquisition. (b) Left frontal FCD marked in Brain Voyager (red) overlaid on anatomical reconstruction with average dipole (green) near the lesion (distance: 4.47 mm). (c) An example of localization with BESA software.
Figure 2
Figure 2
Group “A” patient with right frontal middle gyrus FCD. (a) Coronal MRI FLAIR, (b) DTI anisotropy maps.
See this image and copyright information in PMC

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