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Resection of focal cortical dysplasia located in the upper pre‐central gyrus
Author(s) -
Eldin Samer Serag,
Iwasaki Masaki,
Nishio Yoshiyuki,
Jin Kazutaka,
Nakasato Nobukazu,
Tominaga Teiji
Publication year - 2015
Publication title -
epileptic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 53
eISSN - 1950-6945
pISSN - 1294-9361
DOI - 10.1684/epd.2015.0771
Subject(s) - cortical dysplasia , motor cortex , medicine , cortex (anatomy) , primary motor cortex , neuroscience , epilepsy surgery , lesion , gyrus , anatomy , psychology , epilepsy , surgery , stimulation
The primary motor cortex of the oro‐facial level can be removed without permanent deficits, because of the bilateral representation of the innate functions. In contrast, resective surgery of the hand motor cortex or higher levels presents more challenges. We treated two adult patients with intractable epilepsy caused by small focal cortical dysplasia in the pre‐central gyrus located between the foot and hand primary motor cortices. Focal cortical resection was guided by cortical EEG and intra‐operative motor evoked potential, resulting in seizure freedom without neurological deficits in both cases. These cases illustrate that resective surgery can be safely performed in the primary motor cortex even dorsal to the oro‐facial level, as long as the critical regions of the hand and foot motor cortices remain intact. Accurate delineation of the anatomical lesion and functional areas using intra‐operative neurophysiological monitoring is crucial for successful outcome of the surgery.