Update on Focal Cortical Dysplasia and the Imaging of Epilepsy

Abstract

Epilepsy affects up to 1 in 1,000 children annually. While it is increasingly recognized that forms of epilepsy may have genetic origins, congenital and acquired structural abnormalities of the brain parenchyma are common causes of seizures. Among the most difficult etiologies to diagnose are focal cortical dysplasias, which will be discussed along with their unique imaging features. While magnetic resonance (MR) imaging is the mainstay of epilepsy imaging, magnetoencephalography (MEG) and positon emission tomography (PET) have become increasingly recognized as adding value to the presurgical evaluation of medically refractory epilepsy. More recently, PET/MR hybrid scanning is gaining popularity.

Keywords

epilepsy - focal cortical dysplasia - imaging - magnetoencephalography - positon emission tomography - magnetic resonance

• References

• 1 Schwartz ES, Dlugos DJ, Storm PB. , et al. Magnetoencephalography for pediatric epilepsy: how we do it. Am J Neuroradiol 2008; 29 (05) 832-837
• 2 Taylor DC, Falconer MA, Bruton CJ, Corsellis JA. Focal dysplasia of the cerebral cortex in epilepsy. J Neurol Neurosurg Psychiatry 1971; 34 (04) 369-387
• 3 Bae YS, Kang HC, Kim HD, Kim SH. New classification of focal cortical dysplasia: application to practical diagnosis. J Epilepsy Res 2012; 2 (02) 38-42
• 4 Blümcke I, Spreafico R. An international consensus classification for focal cortical dysplasias. Lancet Neurol 2011; 10 (01) 26-27
• 5 Blümcke I, Thom M, Aronica E. , et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia 2011; 52 (01) 158-174
• 6 Mühlebner A, Coras R, Kobow K. , et al. Neuropathologic measurements in focal cortical dysplasias: validation of the ILAE 2011 classification system and diagnostic implications for MRI. Acta Neuropathol 2012; 123 (02) 259-272
• 7 Schwartz ES, Edgar JC, Gaetz WC, Roberts TP. Magnetoencephalography. Pediatr Radiol 2010; 40 (01) 50-58
• 8 Sutherling WW, Mamelak AN, Thyerlei D. , et al. Influence of magnetic source imaging for planning intracranial EEG in epilepsy. Neurology 2008; 71 (13) 990-996
• 9 Garibotto V, Picard F. Nuclear medicine imaging in epilepsy. Epileptologie 2013; 30: 109-121