ScienceDirect - Epilepsy Research : Characteristics of MEG and MRI between Taylor's focal cortical dysplasia (type II) and other cortical dysplasia: Surgical outcome after complete resection of MEG spike source and MR lesion in pediatric cortical dysplasia

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doi:10.1016/j.eplepsyres.2008.07.013

Characteristics of MEG and MRI between Taylor's focal cortical dysplasia (type II) and other cortical dysplasia: Surgical outcome after complete resection of MEG spike source and MR lesion in pediatric cortical dysplasia

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Elysa Widjaja^a^,^,, Hiroshi Otsubo^b, Charles Raybaud^a, Ayako Ochi^b, Derrick Chan^b, James T. Rutka^c, O. Carter Snead III^b, William Halliday^d, Ryoichi Sakuta^d, Elaine Galicia^b, Ilan Shelef^a and Sylvester H. Chuang^a

^aDiagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8

^bDepartment of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada

^cDepartment of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada

^dDepartment of Pathology, The Hospital for Sick Children, Toronto, Ontario, Canada

Received 6 May 2008;

revised 11 July 2008;

accepted 20 July 2008.

Available online 7 September 2008.

Summary

Purpose

Cortical dysplasia (CD) has been classified as Taylor's focal cortical dysplasia (FCD type II) or other CD (FCD type I and mild malformation of cortical development) based on histological findings. The aims of this study were to determine whether MRI and magnetoencephalography (MEG) could distinguish between these two groups and to evaluate surgical outcomes.

Methods

We evaluated the MRI features, MEG spike source (MEGSS) patterns (clusters or scatters) and postsurgical seizure outcomes of 27 children with CD.

Results

Thirteen patients had Taylor's FCD and 14 had other CD. MRI showed visible lesion in 22 (81%) patients. Tapering of abnormal white matter signals to the ventricles and cortical thickening were more prevalent in Taylor's FCD; focal hypoplasia and white matter atrophy were more prevalent in other CD. MEG showed spike sources in 26 (96%) patients. Taylor's FCD showed clustered MEGSSs in 6, both clustered and scattered MEGSSs in 5 and scattered MEGSSs in 2; other CD demonstrated clusters in 2, cluster and scatter in 10 and scatter in 1. Eleven (85%) of 13 patients who had complete resection of clustered MEGSSs achieved Engel class I outcome, but 4 (44%) of 9 patients with incomplete resections achieved class I. Fifteen (88%) of 17 patients who had complete resection of MRI lesions achieved class I, but 1 (33%) of 3 patients with incomplete lesionectomy was class I. There was no difference in surgical outcomes between Taylor's FCD and other CD.

Conclusions

Surgical outcome was the same in both groups following complete removal of areas containing clustered MEGSSs and MR lesions.

Keywords: Cortical dysplasia; Taylor's focal cortical dysplasia; Magnetic resonance imaging; Magnetoencephalography; Pediatric; MEG spike source

Article Outline

Introduction
Patients and methods Patient population Histological classification MR imaging Magnetoencephalography Surgical procedures and outcome Statistical analysis
Results Histological subtypes and lesion locations MRI findings MEG Surgical outcome
Discussion MEG spike sources between Taylor's FCD and other CD MRI abnormality in Taylor's FCD and other CD Surgical outcome
Conclusions
Acknowledgements
References

Corresponding author. Tel.: +1 416 813 7654; fax: +1 416 813 5789.

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Epilepsy Research
Article in Press, Corrected Proof - Note to users

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