title: "Mirror EPC": epilepsia partialis continua shifting sides after rolandic resection in dysplasia.
abstract: BACKGROUND
  Epilepsia partialis continua (EPC) is a life-threatening condition often caused by focal cortical dysplasia (FCD). Resection of the motor cortex is contemplated in the hope that the trade-off between a severe motor deficit and complete seizure control justifies the procedure.
  
  
  METHODS
  Report of 3 patients with EPC due to histologically confirmed FCD, who underwent resection of the motor cortex under acute electrocorticography.
  
  
  RESULTS
  All had re-emergence of medically intractable EPC in the other side of the body after rolandic resection. Two patients died and the third continues with refractory attacks.
  
  
  CONCLUSIONS
  In some instances, EPC due to FCD may shift sides and re-emerge in the contralateral, previously asymptomatic, hemibody. A mechanism of disinhibition by surgery of a suppressed contralateral and homologous epileptogenic zone is speculated.
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada. martahemb@hotmail.com.
authors.forename: Marta
authors.initials: M
authors.lastname: Hemb
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: Eliseu
authors.initials: E
authors.lastname: Paglioli
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Dubeau
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: Frederick
authors.initials: F
authors.lastname: Andermann
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: André
authors.initials: A
authors.lastname: Olivier
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: Jaderson C
authors.initials: JC
authors.lastname: da Costa
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: William A
authors.initials: WA
authors.lastname: Martins
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: Magda L
authors.initials: ML
authors.lastname: Nunes
authors.affiliation: From the Service of Neurology (M.H., J.C.d.C., W.A.M., M.L.N., A.P.), Service of Neurosurgery (E.P.), Porto Alegre Epilepsy Surgery Program (M.H., E.P., J.C.d.C., A.P.), Department of Internal Medicine, Division of Neurology (J.C.d.C., M.L.N., A.P.), Department of Surgery (E.P.), The Brain Institute (InsCer) (J.C.d.C., M.L.N.), Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; and Montreal Neurological Institute (F.D., F.A., A.O.), Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: André
authors.initials: A
authors.lastname: Palmini
mesh_terms: D000328:Adult; D004569:Electroencephalography; D017036:Epilepsia Partialis Continua / Q000209:etiology / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D054220:Malformations of Cortical Development / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon