Penfield, focal microgyria, and epilepsy

Area of Science:

• Neurobiology
• Epileptology
• Neurosurgery

Background:

• Wilder Penfield was a pivotal figure in 20th-century neurobiology.
• His work significantly advanced understanding of brain function and epilepsy surgery.
• A key discovery regarding microgyria as a cause of epilepsy has been largely overlooked.

Purpose of the Study:

• To provide a comprehensive account of the first documented case of focal epilepsy caused by microgyria.
• To detail the surgical treatment and successful outcome of this case.
• To highlight Penfield's overlooked discovery linking microgyria to epilepsy.

Main Methods:

• Review of primary source documents, including patient charts and operative notes from the Montreal Neurological Institute archives.
• Analysis of Penfield's 1939 Shattuck Lecture.
• Examination of intraoperative photographs, brain maps, and histopathological/cytological findings of the resected specimen.

Main Results:

• Detailed reconstruction of the first case where microgyria was identified as the cause of focal epilepsy.
• Confirmation of successful surgical treatment for this specific case.
• Evidence supporting Penfield's recognition of microgyria's role in generating seizures.

Conclusions:

• Microgyria is a recognized cause of focal epilepsy.
• Surgical intervention can effectively treat epilepsy associated with microgyria.
• This case underscores the importance of Penfield's foundational contributions to epilepsy research and treatment.