Open AccessProblems of diagnosing focal cortical dysplasia
Author(s) -
Kristina D. Yakovleva,
E. A. Kantemirova,
Д. В. Дмитренко
Publication year - 2021
Publication title -
èpilepsiâ i paroksizmalʹnye sostoâniâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.112
H-Index - 1
eISSN - 2311-4088
pISSN - 2077-8333
DOI - 10.17749/2077-8333/epi.par.con.2021.047
Subject(s) - cortical dysplasia , epilepsy , levetiracetam , lacosamide , electroencephalography , temporal lobe , medicine , differential diagnosis , epilepsy surgery , magnetic resonance imaging , generalized epilepsy , neuroscience , psychology , radiology , pathology
Focal cortical dysplasia (FCD) is one of the most common causes in developing pharmacoresistant epilepsy. We present the clinical case of the patient with generalized seizures. Routine electroencephalography (EEG) data registered diffuse epileptiform activity that allowed to diagnose genetic eneralized epilepsy and pharmacoresistant course of seizures.After performing magnetic resonance imaging using the epileptological program and video-EEG-monitoring, the diagnosis was revised: structural focal epilepsy with seizures with focal onset with oroalimentary, gesture automatisms in the right hand, bilateral tonic-clonic, uncompensated by levetiracetam monotherapy (1500 mg/day). Background disease: congenital malformation of the brain: FCD in the basal parts of the left temporal lobe. Lacosamide was added to the therapy in the drug dose 300 mg/day, and the frequency of epileptic seizures decreased. Differential diagnosis between genetic generalized epilepsy and structural epilepsy with FCD usually poses no obstacles. However, in some cases, structural epilepsy occurs under the “mask” of generalized epilepsy. Hence, this clinical case demonstrates the importance of diagnostic measures in the differential diagnostics of various forms of epilepsy to determine further tactics of patient management.