Seizure outcome following primary motor cortex-sparing resective surgery for perirolandic focal cortical dysplasia  Siby Gopinath, Arun Grace Roy, Kollencheri Puthenveetil Vinayan, Anand Kumar, Manjit Sarma, Ramiah Rajeshkannan, Ashok Pillai  International Journal of Surgery  Volume 36, Pages 466-476 (December 2016) DOI: 10.1016/j.ijsu.2015.10.036 Copyright © 2015 IJS Publishing Group Ltd Terms and Conditions

Fig. 1 Resection following noninvasive phase 1 presurgical evaluation in Patient No. 2: Preoperative 3T MRI showing a premotor FCD in axial and coronal FLAIR sequence with corresponding right frontal premotor hypometabolism on FDG-PET imaging. Postresection MRI done 6 months following image- and ECoG-guided resection. Histopathology revealed Type IIb FCD with abundant dysmorphic neurons and balloon cells. International Journal of Surgery 2016 36, 466-476DOI: (10.1016/j.ijsu.2015.10.036) Copyright © 2015 IJS Publishing Group Ltd Terms and Conditions

Fig. 2 Resection following invasive phase 2 evaluation using subdural electrodes with functional mapping in an MRI negative case (Patient No. 9). A focal ictal onset was recorded immediately anterior to the mapped primary motor cortex. FEF = Frontal Eye Fields. International Journal of Surgery 2016 36, 466-476DOI: (10.1016/j.ijsu.2015.10.036) Copyright © 2015 IJS Publishing Group Ltd Terms and Conditions

Fig. 3 SEEG implantation array for an MRI-negative FCD extending from the premotor region in Patient No. 12 (a). SEEG ictal recordings show a focal ictal onset from the depth of the intersecting superior frontal and precentral sulci (b). International Journal of Surgery 2016 36, 466-476DOI: (10.1016/j.ijsu.2015.10.036) Copyright © 2015 IJS Publishing Group Ltd Terms and Conditions

Fig. 4 Acute intraoperative ECoG performed with electrode frame. (a) Electrode tip positions contoured to the cortical surface/lesion. (b) frequent localized polyspiking noted over the lesion. (c) Post-resection ECoG done by contouring electrode tips to resection bed to confirm absence of spike activity. International Journal of Surgery 2016 36, 466-476DOI: (10.1016/j.ijsu.2015.10.036) Copyright © 2015 IJS Publishing Group Ltd Terms and Conditions