Correlation of EEG, neuroimaging and histopathology in an epilepsy patient with diffuse cortical dysplasia

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This is the author-created version of SPRINGER VERLAG, Hashizume, K; Kiriyama, K; Kunimoto, M; Maeda, T; Tanaka, T; Miyamoto, A; Miyokawa, N; Fukuhara, M, CHILD'S NERVOUS SYSTEM, 16(2), 2000, 75-79. The original publication is available at www.springerlink.com.authorThe correlation between scalp EEG, intraoperative electrocorticogram, neuroimaging and histopathology was examined in a epilepsy child with diffuse cortical dysplasia. A 6-year-old girl with moderate mental retardation had suffered from intractable complex partial and generalized epilepsy since 2-year-old. MR images demonstrated unilateral large macrogyria/polymicrogyria and schizencephaly in the right occipital lobe. The epileptic focus was detected on the macrogyria by EEG and single-photon emission tomography. However, intraoperative electrocorticogram showed frequent spikes from the polymicrogyria and no paroxysmal activity in the macrogyria. The polymicrogyria was resected including the macrogyria using an image-guided system. The histological findings revealed that the macrogyria was covered and separated with glial bundles. It has been reported that epileptogenisity was produced from abnormal neurons and their arrangement in cortical dysplasia, however in this case, the major dysplastic lesion had no epileptogenisity, rather the focus might be in polymicrogyria around the lesion.