Complex central cortex in pediatric patients with malformations of cortical development.
We investigated whether malformations of cortical development yield a complex central cortex by studying nine children with malformations of cortical development and seven without malformations who underwent epilepsy surgery following extraoperative subdural somatosensory evoked potential and electrical stimulation to identify the sensorimotor cortex. We analyzed superficial structures of the central cortex, latency, amplitude, and location of N20 and P25. Sensorimotor responses in malformations of cortical development extended across the central sulcus in 1 to 4 of 3 to 12 electrodes (mean 32%) compared with 1 to 6 of 4 to 15 electrodes (mean 12%) in cases without malformations with a statistical significance (P < .05). N20 amplitudes were lower in epileptic than nonepileptic cortices (three with and three without malformations of cortical development) (P < .05). The central vein coursed partially along the central sulcus in eight cases of malformations of cortical development and five cases without malformations. We conclude that the sensorimotor cortex in malformations of cortical development is more complex than in cases without malformations, reduced N20 amplitude is indicative of epileptic sensorimotor cortex, and superficial veins do not indicate the sensory and motor cortical boundary.
Akai
Takuya
T
Department of Pediatrics and Surgery, The Hospital for Sick Children, Toronto, Ontario.
Otsubo
Hiroshi
H
Pang
Elizabeth W
EW
Rutka
James T
JT
Chitoku
Shiro
S
Weiss
Shelly K
SK
Snead
O Carter
OC
D000293:Adolescent; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013003:Somatosensory Cortex / Q000503:physiopathology / Q000601:surgery