OBJECTIVE: Dysplasia at the bottom of a sulcus is a subtle but distinct malformation of cortical development relevant to epilepsy. The purpose of this study was to review the imaging features important to the clinical diagnosis of this lesion. MATERIALS AND METHODS: All cases recognized as typical bottom-of-sulcus dysplasia in our comprehensive epilepsy program over the period 2002-2007 were included in the study. RESULTS: In the 20 cases recognized, three major features were identified: cortical thickening at the bottom of a sulcus; a funnel-shaped extension of the lesion toward the ventricular surface, commonly with abnormal signal intensity; and an abnormal gyral pattern related to the bottom-of-sulcus dysplasia, sometimes with a puckered appearance. The pathologic features of the resected lesions were typical of focal cortical dysplasia. CONCLUSION: Bottom-of-sulcus dysplasia is a distinctive malformation of cortical development that can be diagnosed on the basis of imaging characteristics. Reliable identification of this type of malformation of cortical development is difficult but clinically important because the lesion appears to be highly epileptogenic and because the prognosis for seizure control is excellent after focal resection.
OBJECTIVE:Dysplasia at the bottom of a sulcus is a subtle but distinct malformation of cortical development relevant to epilepsy. The purpose of this study was to review the imaging features important to the clinical diagnosis of this lesion. MATERIALS AND METHODS: All cases recognized as typical bottom-of-sulcus dysplasia in our comprehensive epilepsy program over the period 2002-2007 were included in the study. RESULTS: In the 20 cases recognized, three major features were identified: cortical thickening at the bottom of a sulcus; a funnel-shaped extension of the lesion toward the ventricular surface, commonly with abnormal signal intensity; and an abnormal gyral pattern related to the bottom-of-sulcus dysplasia, sometimes with a puckered appearance. The pathologic features of the resected lesions were typical of focal cortical dysplasia. CONCLUSION: Bottom-of-sulcus dysplasia is a distinctive malformation of cortical development that can be diagnosed on the basis of imaging characteristics. Reliable identification of this type of malformation of cortical development is difficult but clinically important because the lesion appears to be highly epileptogenic and because the prognosis for seizure control is excellent after focal resection.
Authors: Bilal Ahmed; Carla E Brodley; Karen E Blackmon; Ruben Kuzniecky; Gilad Barash; Chad Carlson; Brian T Quinn; Werner Doyle; Jacqueline French; Orrin Devinsky; Thomas Thesen Journal: Epilepsy Behav Date: 2015-05-31 Impact factor: 2.937
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Authors: A Simon Harvey; Simone A Mandelstam; Wirginia J Maixner; Richard J Leventer; Mira Semmelroch; Duncan MacGregor; Renate M Kalnins; Yuliya Perchyonok; Gregory J Fitt; Sarah Barton; Michael J Kean; Gavin C A Fabinyi; Graeme D Jackson Journal: Neurology Date: 2015-04-17 Impact factor: 9.910
Authors: A James Barkovich; Renzo Guerrini; Ruben I Kuzniecky; Graeme D Jackson; William B Dobyns Journal: Brain Date: 2012-03-16 Impact factor: 13.501
Authors: Caterina Shepherd; Joan Liu; Joanna Goc; Lillian Martinian; Thomas S Jacques; Sanjay M Sisodiya; Maria Thom Journal: Epilepsia Date: 2013-03-28 Impact factor: 5.864