title: Local epileptic activity, histological and neuroimaging findings in symptomatic epilepsy.
abstract: OBJECTIVE
  This study is aimed at revealing the relationship between local interictal epileptic activity, cytoarchitectural disturbances and magnetic resonance imaging (MRI) findings.
  
  
  METHODS
  We prospectively investigated a series of 25 patients with symptomatic epilepsy due to isolated forms of focal cortical dysplasia (FCD) or hippocampal sclerosis and low-grade tumours associated with FCD, all of whom underwent tailored surgical procedures under intraoperative electrocorticography; we conducted neuropathological examinations of 92 biopsies taken from different places. We examined the relationship between dysplastic changes in the cortex and the absence or presence of seizure patterns (SPs), including regular spikes/sharp waves, recruiting discharges, paroxysmal fast activity and rhythmic delta-theta activity. Comparisons with MRI findings were also performed.
  
  
  RESULTS
  Complete removal of the SPs zone was associated with better results of surgical treatment. Areas with isolated architectural abnormalities were associated with SPs significantly more often than those where the cortex contains immature or giant neurons; these areas were associated with SPs more than areas containing dysmorphic neurons. The extent of MRI signs appearance in the neocortex correlated neither with the presence of SPs nor with the types of histological changes.
  
  
  CONCLUSIONS
  We suppose an inverse relationship between the morphological changes in neurons and their ability to generate epileptic activity. Electrocorticography may be used for the identification of the MRI-negative epileptogenic lesions.
authors.affiliation: N.N. Burdenko Neurosurgery Institute, Moscow, Russia. a.stepanenko61@gmail.com
authors.forename: A Y
authors.initials: AY
authors.lastname: Stepanenko
authors.forename: N A
authors.initials: NA
authors.lastname: Arkhipova
authors.forename: L V
authors.initials: LV
authors.lastname: Shishkina
authors.forename: I N
authors.initials: IN
authors.lastname: Pronin
authors.forename: A Y
authors.initials: AY
authors.lastname: Lubnin
authors.forename: A V
authors.initials: AV
authors.lastname: Lebedeva
authors.forename: A B
authors.initials: AB
authors.lastname: Guekht
mesh_terms: D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D015331:Cohort Studies; D004569:Electroencephalography; D004827:Epilepsy / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D059906:Neuroimaging; D016896:Treatment Outcome; D055815:Young Adult