Combined SEEG and source localisation study of temporal lobe schizencephaly and polymicrogyria.

Full Abstract

OBJECTIVES: Type 1 schizencephaly (SZ) is a cerebral malformation characterised by a cleft lined and surrounded by a polymicrogyric cortex, extending from the pial region to the peri-ventricular heterotopia. Our purpose was to combine and compare dipole source imaging technique and Stereo-EEG (SEEG) technique in determining the irritative and epileptogenic zones in a case of type 1 schizencephaly. METHODS: High-resolution (64-channel) video-EEG with electrical source imaging and SEEG recordings were performed during a pre-surgical evaluation for medically intractable epilepsy. RESULTS: Anatomo-electro-clinical correlations based on SEEG and source localisation identified two irritative and epileptogenic zones partially overlapping the polymicrogyric cortex surrounding the SZ: an anterior medio-lateral network primarily involving dysplasic limbic structures and a lateral network involving the anterior and middle part of the cleft and polymicrogyric cortex. The most posterior part (at the temporo-parieto-occipital junction) displayed a normal background activity. CONCLUSIONS: Both epileptogenic and electrophysiologically normal cortices coexisted within the same widespread malformation: only the anterior part belonged to the anterior medio-lateral epileptogenic network defined by the SEEG. SIGNIFICANCE: In cases of widespread cortical malformation such as SZ, source localization techniques can help to define the irritative zone and relevant targets for SEEG.

Author information

Author/s: Maillard, L (L); Koessler, L (L); Colnat-Coulbois, S (S); Vignal, J-P (JP); Louis-Dorr, V (V); Marie, P-Y (PY); Vespignani, H (H);

Affiliation: Service de Neurologie, Centre Hospitalier Universitaire de Nancy, France. l.maillard(-atsign-)chu-nancy.fr

Journal and publication information

Publication Type: Case Reports; Journal Article

Journal: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology (Clin Neurophysiol), published in Netherlands. (Language: eng)

Reference: 2009-Sep; vol 120 (issue 9) : pp 1628-36

Dates: Created 2009/09/08; Completed 2009/09/23;

PMID: 19632148, status: MEDLINE (last retrieval date: 9/23/2009, IMS Date: )

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