[Multiple focal cortical dysplasias presenting with intractable epilepsy: case report]
1Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
No to Shinkei = Brain and Nerve
|December 1, 2001
Summary
This case report details a 14-year-old with intractable epilepsy due to multiple focal cortical dysplasias (FCD). Surgical resection of the right frontal lesion reduced seizure frequency but did not eliminate seizures, highlighting the need for refined strategies.
Area of Science:
- Neurology
- Neurosurgery
- Epileptology
Background:
- Intractable epilepsy in adolescents can be associated with focal cortical dysplasia (FCD).
- Accurate localization of the seizure onset zone is critical for surgical planning in FCD.
Observation:
- A 14-year-old female presented with intractable frontal lobe epilepsy and multiple FCD lesions across different brain lobes.
- Electroencephalography (EEG) and Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) indicated a right frontal lobe seizure onset.
- Intraoperative monitoring confirmed the ictal onset zone in the right frontal lesion, leading to surgical resection.
Findings:
- Post-surgical resection, the patient experienced a decrease in seizure frequency, but residual seizures persisted.
- This outcome suggests that while surgical intervention can be beneficial, complete seizure control may be challenging in cases of multiple FCD.
Implications:
- Further research is warranted to optimize surgical indications and strategies for patients with multiple focal cortical dysplasias.
- Individualized treatment approaches may be necessary to achieve satisfactory seizure outcomes in complex FCD cases.
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