Heterogeneous epileptogenicity and cortical function within malformations of cortical development: a case report

Area of Science:

• Neuroscience
• Epileptology
• Neurosurgery

Background:

• Intractable partial epilepsy often presents challenges in management, particularly when associated with malformations of cortical development (MCD).
• Accurate localization of the epileptogenic zone is critical for effective surgical intervention.

Observation:

• A 24-year-old patient with severe, drug-resistant epilepsy and extensive MCD was studied.
• Subdural electroencephalography (EEG) revealed heterogeneous epileptogenicity within the malformed cortex.
• Visual evoked potentials indicated functional cortical areas adjacent to the primary seizure focus.

Findings:

• Surgical resection targeted a small cortical region identified as the core epileptogenic zone.
• The procedure preserved adjacent functionally important cortical areas.
• Postoperative outcomes demonstrated significant seizure improvement.

Implications:

• This case highlights the potential for precise surgical targeting in epilepsy associated with MCD.
• Preserving functional cortical areas during epilepsy surgery is achievable and crucial for preventing neurological deficits.
• This approach offers a promising strategy for managing complex epilepsy cases.