Purpose or Case Report: Imaging features and evaluation of focal cortical dysplasias (FCDs).
Methods & Materials: Discuss the role of imaging in investigation of focal cortical dysplasias in epileptic pediatric patients.
Results: FCDs are an important cause for medication refractory focal seizures in the pediatric population. FCDs are characterized by abnormal cortical architecture and gray-white matter junction differentiation. Extensive preoperative electrophysiological investigations such as electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) are performed to guide electrode implantation and map out surgical treatment of the epileptogenic focus. Despite considerable progress in the preoperative investigatory techniques, FCD-related epilepsy remains difficult to diagnose and treat. The comprehensive three-tiered International League Against Epilepsy (ILAE) classification system of FCD is used to distinguish this diverse clinicopathological entity. This exhibit will describe the MRI and PET imaging features of various types of FCDs based on the above mentioned classification system. Limitations of current imaging techniques in identification of FCD and reasons for discrepant imaging and electrophysiological studies will also be described.
Conclusions: Imaging plays an important role in defining the cause for focal epilepsy in the pediatric patient, the characterization of which guides treatment with the goal of a seizure-free life after surgery.