Appearance of focal cortical dysplasia on serial MRI after maturation of myelination.
METHODS
It is well known that magnetic resonance imaging (MRI) findings of focal cortical dysplasia (FCD) can change with maturation of myelination. In this paper, we report a patient with intractable epilepsy and negative MRI at the age of 2.5 years, after completion of myelination. Follow-up MRI at the age of 6 years revealed typical FCD findings in the right frontal lobe. During these 3.5 years, electroencephalogram (EEG) consistently depicted an area of irritation in accordance with de novo MRI findings. Intraoperative electrocorticogram showed frequent paroxysmal activity in the right frontal lobe; excision of the epileptogenic cortex resulted in a reduction in seizures.


CONCLUSIONS
It is possible that FCD becomes apparent on MRI even after maturation of myelination; thus, repeated MRI is recommended while EEG continues to demonstrate focal findings.
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
Fumiaki
F
Yoshida
Takato
T
Morioka
Kimiaki
K
Hashiguchi
Yasushi
Y
Miyagi
Shinji
S
Nagata
Yui
Y
Yamaguchi
Masaharu
M
Ohfu
Tomio
T
Sasaki
D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging* / Q000254:growth & development*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D009413:Nerve Fibers, Myelinated / Q000000981:diagnostic imaging*; D011859:Radiography; D012640:Seizures / Q000209:etiology / Q000601:surgery
D000927:Anticonvulsants