Journal article

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

Emma Macdonald-Laurs, Wirginia J Maixner, Catherine A Bailey, Sarah M Barton, Simone A Mandelstam, Joseph Yuan-Mou Yang, Aaron EL Warren, Michael J Kean, Peter Francis, Duncan MacGregor, Colleen D'Arcy, Jacquie A Wrennall, Andrew Davidson, Kate Pope, Richard J Leventer, Jeremy L Freeman, Alison Wray, Graeme D Jackson, A Simon Harvey



OBJECTIVE: To determine whether 1-stage, limited corticectomy controls seizures in patients with MRI-positive, bottom-of-sulcus dysplasia (BOSD). METHODS: We 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. RESULTS: Thirty-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..

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