title: Bottom-of-sulcus dysplasia: imaging features.
abstract: OBJECTIVE
  Dysplasia at the bottom of a sulcus is a subtle but distinct malformation of cortical development relevant to epilepsy. The purpose of this study was to review the imaging features important to the clinical diagnosis of this lesion.
  
  
  METHODS
  All cases recognized as typical bottom-of-sulcus dysplasia in our comprehensive epilepsy program over the period 2002-2007 were included in the study.
  
  
  RESULTS
  In the 20 cases recognized, three major features were identified: cortical thickening at the bottom of a sulcus; a funnel-shaped extension of the lesion toward the ventricular surface, commonly with abnormal signal intensity; and an abnormal gyral pattern related to the bottom-of-sulcus dysplasia, sometimes with a puckered appearance. The pathologic features of the resected lesions were typical of focal cortical dysplasia.
  
  
  CONCLUSIONS
  Bottom-of-sulcus dysplasia is a distinctive malformation of cortical development that can be diagnosed on the basis of imaging characteristics. Reliable identification of this type of malformation of cortical development is difficult but clinically important because the lesion appears to be highly epileptogenic and because the prognosis for seizure control is excellent after focal resection.
authors.affiliation: Brain Research Institute, Florey Neuroscience Institutes, Heidelberg West, Victoria, Australia. paul.hofman@mumc.nl
authors.forename: Paul A M
authors.initials: PA
authors.lastname: Hofman
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Fitt
authors.forename: A Simon
authors.initials: AS
authors.lastname: Harvey
authors.forename: Ruben I
authors.initials: RI
authors.lastname: Kuzniecky
authors.forename: Graeme
authors.initials: G
authors.lastname: Jackson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D054220:Malformations of Cortical Development / Q000175:diagnosis*