O28 Advanced dynamic statistical parametric mapping (ADSPM) for focal cortical dysplasia at bottom of sulcus

Our current purpose is to evaluate the applicability of dynamic statistical parametric mapping, a novel method for localizing epileptiform activity recorded with magnetoencephalography in patients with epilepsy. We report four pediatric patients with focal epilepsies. Magnetoencephalographic data were collected with a 306-channel whole-head helmet-shaped sensor array. We calculated equivalent current dipoles and dynamic statistical parametric mapping movies of the interictal epileptiform discharges that were based in the minimum-L2 norm estimate, minimizing the square sum of the dipole element amplitudes. The dynamic statistical parametric mapping analysis of interictal epileptiform discharges can demonstrate the rapid change and propagation of interical epileptiform discharges. According to these findings, specific epileptogenic lesion—focal cortical dysplasia could be found and patients could be operated on successfully. The presurgical analysis of interictal epileptiform discharges using dynamic statistical parametric mapping seems to be promising in patients with a possible underlying focal cortical dysplasia and might help to guide the placement of invasive electrodes. ( J Child Neurol 2005;20:363—369).

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Detection of epileptogenic focus using advanced dynamic statistical parametric mapping with magnetoencephalography in a patient with MRI-negative focal cortical dysplasia type IIB

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.7.peds1948 ◽

2020 ◽

Vol 25 (1) ◽

pp. 78-82 ◽

Cited By ~ 1

Author(s):

Won Seok Chang ◽

Midori Nakajima ◽

Ayako Ochi ◽

Elysa Widjaja ◽

James T. Rutka ◽

...

Keyword(s):

Focal Epilepsy ◽

Histopathological Examination ◽

Focal Cortical Dysplasia ◽

Statistical Parametric Mapping ◽

Cortical Dysplasia ◽

Type I ◽

Head Turning ◽

Parametric Mapping ◽

The Right ◽

Video Eeg

Advanced dynamic statistical parametric mapping (AdSPM) with magnetoencephalography (MEG) was used to identify MRI-negative epileptogenic lesions in this report. A 15-year-old girl had MRI-negative and pharmacology-resistant focal-onset epilepsy. She experienced two types of seizures. Type I consisted of her arousal from sleep, staring, and a forced head-turning movement to the left, followed by secondary generalization. Type II began with an aura of dizziness followed by staring and postictal headache with fatigue. Scalp video-electroencephalography (EEG) captured two type I seizures originating from the right frontocentral region. MEG showed scattered dipoles over the right frontal region. AdSPM identified the spike source at the bottom of the right inferior frontal sulcus. Intracranial video-EEG captured one type I seizure, which originated from the depth electrode at the bottom of the sulcus and correlated with the AdSPM spike source. Accordingly, the patient underwent resection of the middle and inferior frontal gyri, including the AdSPM-identified spike source. Histopathological examination revealed that the patient had focal cortical dysplasia type IIB. To date, the patient has been seizure free for 2 years while receiving topiramate treatment. This is the first preliminary report to identify MRI-negative epilepsy using AdSPM. Further investigation of AdSPM would be valuable for cases of MRI-negative focal epilepsy.

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Reorganization of the primary somatosensory area in epilepsy associated with focal cortical dysplasia

Developmental Medicine & Child Neurology ◽

10.1017/s0012162200001547 ◽

2001 ◽

Vol 42 (12) ◽

pp. 839 ◽

Cited By ~ 7

Author(s):

Kenjiro Gondo ◽

Ryutaro Kira ◽

Yoichi Tokunaga ◽

Chie Harashima ◽

Shozo Tobimatsu ◽

...

Keyword(s):

Focal Cortical Dysplasia ◽

Cortical Dysplasia ◽

Somatosensory Area

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Ultrasonographic Features of Focal Cortical Dysplasia and Their Relevance for the Surgical Treatment of Epilepsy

10.1055/s-0038-1660699 ◽

2018 ◽

Author(s):

K. Akeret ◽

D. Bellut ◽

H. Huppertz ◽

C. Serra ◽

K. König ◽

...

Keyword(s):

Surgical Treatment ◽

Focal Cortical Dysplasia ◽

Cortical Dysplasia ◽

Treatment Of Epilepsy

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Utility of depth electrode placement in the neurosurgical management of bottom-of-sulcus lesions: technical note

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.4.peds18639 ◽

2019 ◽

Vol 24 (3) ◽

pp. 284-292

Author(s):

Eisha A. Christian ◽

Elysa Widjaja ◽

Ayako Ochi ◽

Hiroshi Otsubo ◽

Stephanie Holowka ◽

...

Keyword(s):

Pediatric Patients ◽

Focal Cortical Dysplasia ◽

Target Identification ◽

Cortical Dysplasia ◽

Technical Note ◽

Electrode Placement ◽

Electrode Implantation ◽

Depth Electrodes ◽

Intracranial Electrode ◽

The Brain

OBJECTIVESmall lesions at the depth of the sulcus, such as with bottom-of-sulcus focal cortical dysplasia, are not visible from the surface of the brain and can therefore be technically challenging to resect. In this technical note, the authors describe their method of using depth electrodes as landmarks for the subsequent resection of these exacting lesions.METHODSA retrospective review was performed on pediatric patients who had undergone invasive electroencephalography with depth electrodes that were subsequently used as guides for resection in the period between July 2015 and June 2017.RESULTSTen patients (3–15 years old) met the criteria for this study. At the same time as invasive subdural grid and/or strip insertion, between 2 and 4 depth electrodes were placed using a hand-held frameless neuronavigation technique. Of the total 28 depth electrodes inserted, all were found within the targeted locations on postoperative imaging. There was 1 patient in whom an asymptomatic subarachnoid hemorrhage was demonstrated on postprocedural imaging. Depth electrodes aided in target identification in all 10 cases.CONCLUSIONSDepth electrodes placed at the time of invasive intracranial electrode implantation can be used to help localize, target, and resect primary zones of epileptogenesis caused by bottom-of-sulcus lesions.

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