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Malformations of Cortical Development

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MRI in Epilepsy

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Malformations of cortical development are arranged in different ways. Recently, the ILAE published a consensus classification incorporating pathological, imaging, and genetic findings (Blümcke et al. 2011). Some lesions (namely FCD 2B) from this classification are clearly visible on MRI and pathologically classified with a high concordance between different pathologists. If they are fully resected, seizure freedom rate is > 80 %. Other lesions (namely FCD 1) are more difficult to detect or “unvisible” even with voxel-based MRI analyses and harbored with a high interrater-variability between different pathologists. Chance of postsurgical seizure freedom is distinctly < 50 %. A patient will likely benefit from surgery if a distinct MRI lesion is found underlining the importance of high-quality MRI acquisition and interpretation.

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Urbach, H., Greschus, S. (2013). Malformations of Cortical Development. In: Urbach, H. (eds) MRI in Epilepsy. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_749

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