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Retained language in dysgenic cortex: case report

R Leblanc1, Y Robitaille, F Andermann

  • 1Department of Neurology & Neurosurgery, Montreal Neurological Institute & Hospital, Quebec, Canada.

Neurosurgery
|November 1, 1995
PubMed
Summary
This summary is machine-generated.

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Dysplastic cortex, often linked to epilepsy, can remain functional. Pre-surgical mapping is crucial for patients with intractable epilepsy and lesions in speech areas.

Area of Science:

  • Neuroscience
  • Epileptology

Background:

  • Disorders of cortical migration are increasingly studied for their role in focal epilepsy.
  • The functional capacity of dysplastic cortex remains poorly understood.

Observation:

  • A 46-year-old left-handed woman with a 30-year history of complex partial seizures underwent evaluation for a right posterotemporal lesion.
  • Electroencephalography identified an epileptic focus in the right temporal lobe; imaging suggested a hamartoma.
  • Intraoperative stimulation of the lesion caused speech interference, and Amytal testing indicated right-hemisphere speech dominance.

Findings:

  • Histological examination revealed extensive multifocal cortical microdysgenesis and a gliovascular and cortical hamartoma.
  • Despite its dysplastic nature, the lesion appeared to retain some function, evidenced by speech interference upon stimulation.

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Implications:

  • This case highlights that grossly dysplastic cortex can be functional.
  • Pre-operative cortical mapping under local anesthesia is recommended before resecting dysplastic lesions in eloquent brain regions of epilepsy patients.