Journal article

One-Stage, Limited-Resection Epilepsy Surgery for Bottom-of-Sulcus Dysplasia

E Macdonald-Laurs, WJ Maixner, CA Bailey, SM Barton, SA Mandelstam, J Yuan-Mou Yang, AEL Warren, MJ Kean, P Francis, D Macgregor, C D'Arcy, JA Wrennall, A Davidson, K Pope, RJ Leventer, JL Freeman, A Wray, GD Jackson, AS Harvey

Neurology | Published : 2021

Abstract

Objective To determine whether 1-stage, limited corticectomy controls seizures in patients with MRI-positive, bottom-of-sulcus dysplasia (BOSD).MethodsWe reviewed clinical, neuroimaging, electrocorticography (ECoG), operative, and histopathology findings in consecutively operated patients with drug-resistant focal epilepsy and MRI-positive BOSD, all of whom underwent corticectomy guided by MRI and ECoG.ResultsThirty-eight patients with a median age at surgery of 10.2 (interquartile range [IQR] 6.0-14.1) years were included. BOSDs involved eloquent cortex in 15 patients. Eighty-seven percent of patients had rhythmic spiking on preresection ECoG. Rhythmic spiking was present in 22 of 24 patien..

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