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.
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.
Authors: A De Ciantis; A J Barkovich; M Cosottini; C Barba; D Montanaro; M Costagli; M Tosetti; L Biagi; W B Dobyns; R Guerrini Journal: AJNR Am J Neuroradiol Date: 2014-09-25 Impact factor: 3.825
Authors: Michel Alhilani; Eleonora Tamilia; Lorenzo Ricci; Laura Ricci; P Ellen Grant; Joseph R Madsen; Phillip L Pearl; Christos Papadelis Journal: Clin Neurophysiol Date: 2020-01-20 Impact factor: 3.708
Authors: Laurent Koessler; Sophie Colnat-Coulbois; Thierry Cecchin; Janis Hofmanis; Jacek P Dmochowski; Anthony M Norcia; Louis G Maillard Journal: Hum Brain Mapp Date: 2016-10-11 Impact factor: 5.038
Authors: Doris D Wang; Renatta Knox; John D Rolston; Dario J Englot; A James Barkovich; Tarik Tihan; Kurtis I Auguste; Robert C Knowlton; Susannah B Cornes; Edward F Chang Journal: Epilepsia Date: 2015-12-09 Impact factor: 5.864