Focal cortical dysplasia (FCD) is often associated with severe focal epilepsy. Intraoperative ECoG showed one of the following patterns: (1) repetitive.

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Date of download: 6/23/2016 Copyright © 2016 McGraw-Hill Education. All rights reserved. Supplementary Sensorimotor Area (SSMA) Seizure; Subdural vs Scalp.

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Presentation transcript:

Focal cortical dysplasia (FCD) is often associated with severe focal epilepsy. Intraoperative ECoG showed one of the following patterns: (1) repetitive electrographic seizures, (2) repetitive bursting discharges, or (3) continuous or quasicontinuous rhythmic spiking. One or more of these patterns were present in 67% with intractable focal epilepsy associated with FCD and, in only 2.5% with intractable focal epilepsy, were associated with other types of structural lesions. These ictal or continuous epileptogenic discharges (I/CEDs) were usually localized, which contrast with the more widespread interictal ECoG epileptic activity, and tended to correspond with the lesion seen in the MRI. Complete resection of the FCD displaying I/CEDs correlated with good surgical outcome. Three-fourths of the patients in whom the FCD displaying I/CEDs was entirely excised had favorable surgical outcome. FCDs are highly and intrinsically epileptogenic, and intraoperative ECoG identification of this intrinsically epileptogenic dysplastic cortical tissue is critical to decide the extent of excision.73 Source: Focal Epilepsy, Atlas of Pediatric EEG Citation: Laoprasert P. Atlas of Pediatric EEG; 2011 Available at: https://neurology.mhmedical.com/DownloadImage.aspx?image=/data/books/1042/lao001_fig_09-157.gif&sec=59080224&BookID=1042&ChapterSecID=59078731&imagename= Accessed: October 30, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved