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The Importance of Magnetic Resonance in Detection of Cortical Dysplasia
Fjolla Hyseni1, Ilir Ahmetgjekaj2, Valon Vokshi3
1Medical Researcher, NYU Langone Health, New York, USA.
Insights
Focal cortical dysplasia (FCD), a brain malformation, is a common cause of refractory epilepsy. This case highlights MRI
Area of Science:
- Neuroscience
- Neurology
- Developmental Neuroscience
Background:
- Focal cortical dysplasia (FCD) is a significant cause of intractable epilepsy, particularly in pediatric and adult populations.
- It involves abnormalities in cortical lamination, neuronal maturation, and differentiation, leading to seizures.
- Understanding FCD subtypes is crucial for effective epilepsy management.
Observation:
- A 23-year-old female presented with loss of consciousness and convulsions.
- MRI revealed a 5mm cortical thickening in the right superior temporal gyrus, measuring 24x16mm.
- No mesial temporal sclerosis or hippocampal abnormalities were detected.
Findings:
- The MRI findings were consistent with Focal Cortical Dysplasia Type 1.
- This subtype of FCD can present with subtle or no MRI abnormalities.
- Temporal lobe involvement is common in detectable FCD Type 1 cases.
Implications:
- This case underscores the critical role of MRI in diagnosing FCD, even subtle Type 1 cases.
- Early and accurate detection of FCD through neuroimaging aids in appropriate treatment strategies.
- Further research into FCD subtypes can improve epilepsy treatment outcomes.
Abstract:
Focal cortical dysplasia is a malformation of cortical development in which there are abnormalities with cortical lamination, neuronal maturation, and neuronal differentiation. It is the most common cause of medically refractory epilepsy in the pediatric population and the second/third most common etiology of medically intractable seizures in adults. Herein, we present the case of 23-years-old female patient, presenting with loss of consciousness, and convulsions. A MRI revealed a 5mm cortical thickening on either side of the posterior aspect of the right superior temporal gyrus without transmantle extension towards ventricle. This abnormal area is measured about 24x16mm and there was no evidence for mesial temporal sclerosis. Both hippocampi are normal is size, morphology and signal. These features are consistent with cortical dysplasia type 1. This case report emphasizes the importance of MRI in the detection of FCD. MRI can show no abnormalities in type 1 FCD, but when the changes are apparent, they are on the temporal lobe, and seizures presents most commonly in adults.
