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Review
. 2021 Dec;75(6):462-466.
doi: 10.5455/medarh.2021.75.462-466.

Focal Cortical Dysplasia and Generalized Epileptiform Discharges: Case Report and Literature Review

Hanin Algethami  1 , Vahe Poghosyan  2 , Eman Baksh  3 , Majed Alhameed  4
Affiliations
Review

Focal Cortical Dysplasia and Generalized Epileptiform Discharges: Case Report and Literature Review

Hanin Algethami et al. Med Arch. 2021 Dec.

Abstract

Background: Focal epilepsy can have a varied etiology, including malformations of cortical development (MCD), that can often be detected by Magnetic Resonance Imaging (MRI).Here we show a distinct characteristic of two forms of MCDs on MRI, with two tight dipole clusters in her MEG magnetoencephalography study, in a patient with electroencephalography (EEG) features of generalized epilepsy.

Case report: This is a case presentation of a 20 years old female with epilepsy, found to have upon EMU admission two pathologies (FCD, heterotropia) over the right side near the collateral sulcus, and two tight clusters of dipoles over the right parietal and left temporo-parietal region, with generalized inter ictal discharges in her EEG. FCD is a common etiology of medically intractable seizures and usually in EEG it will show either: pseudo-periodic spikes or rhythmic spikes, poly-spike or repetitive electrographic seizures or a brief discharge of fast rhythmic activity, atypical presentation with generalized epileptiform discharges were rarely reported.

Conclusion: The presence of MCD does not preclude a patient from having other types of epilepsy. Generalized epilepsy and focal related epilepsy have a distinct pathophysiology.

Keywords: EEG; Epilepsy; MEG; MRI; focal cortical dysplasia.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1.
Figure 1.. Generalized synchronized spike-poly-spike and slow wave complexes.
Figure 2.
Figure 2.. Generalized synchronized spike-poly-spike and slow wave complexes
Figure 3.
Figure 3.. T2 axial cut showing subependymal grey matter heterotopia
Figure 4.
Figure 4.. T2 coronal cut showing cortical thickening along the right collateral sulcus and subependymal grey matter heterotopia
Figure 5.
Figure 5.. MEG dipoles localized to the left posterior lateral/Sylvian fissure
Figure 6.
Figure 6.. MEG dipoles localized to the posterior part of the right superior temporal sulcus (inferior parietal lobule)
See this image and copyright information in PMC

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