title: Multimodality neuroimaging evaluation improves the detection of subtle cortical dysplasia in seizure patients.
abstract: The purpose of this study is to investigate if multimodality neuroimaging evaluation increases the detection of subtle focal cortical dysplasia as part of an epilepsy surgery evaluation. Three patients with normal magnetic resonance imaging and histopathological findings of focal cortical dysplasia were reviewed. Their magnetoencephalography recordings were performed on whole-head magnetoencephalography system. Magnetic resonance images were re-evaluated with special inspection in limited regions guided by magnetoencephalography spike localization. Two patients had ictal and interictal single photon emission computed tomography study after administration of Tc99m ECD. In two patients we found tiny focal abnormalities including slightly increased cortical thickness and blurred gray-white matter junction at the locations of interictal events after re-evaluation of the MR images indicating focal cortical dysplasia. The third patient showed focal atrophic change. All patients are seizure free after surgery. Both ictal and interictal single photon emission computed tomography showed hyperperfusion in the dysplastic cortex regions. Multimodality neuroimaging study can improve the detection of focal cortical dysplasia. Normal magnetic resonance images should be re-evaluated for subtle signs of focal cortical dysplasia especially when magnetoencephalography recording demonstrate focal epileptic discharges.
authors.affiliation: Department of Neurosurgery, Vivian L. Smith Center for Neurologic Research, Texas Comprehensive Epilepsy Program, University of Texas-Health Science Center at Houston, 1333 Moursund Street, Ste H114, Houston, TX 77030, USA. wenbo.zhang@uth.tmc.edu
authors.forename: Wenbo
authors.initials: W
authors.lastname: Zhang
authors.forename: Panagiotis G
authors.initials: PG
authors.lastname: Simos
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: James W
authors.initials: JW
authors.lastname: Wheless
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Castillo
authors.forename: Howard L
authors.initials: HL
authors.lastname: Kim
authors.forename: James E
authors.initials: JE
authors.lastname: Baumgartner
authors.forename: Shirin
authors.initials: S
authors.lastname: Sarkari
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Papanicolaou
mesh_terms: D000293:Adolescent; D002540:Cerebral Cortex / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D017029:Epilepsy, Complex Partial / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed