Resection of focal cortical dysplasia located in the upper pre-central gyrus

Samer Serag Eldin, Masaki Iwasaki, Yoshiyuki Nishio, Kazutaka Jin, Nobukazu Nakasato, Teiji Tominaga

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

The primary motor cortex of the oro-facial level can be removed without permanent deficits, because of the bilateral representation of the innate functions. In contrast, resective surgery of the hand motor cortex or higher levels presents more challenges. We treated two adult patients with intractable epilepsy caused by small focal cortical dysplasia in the pre-central gyrus located between the foot and hand primary motor cortices. Focal cortical resection was guided by cortical EEG and intra-operative motor evoked potential, resulting in seizure freedom without neurological deficits in both cases. These cases illustrate that resective surgery can be safely performed in the primary motor cortex even dorsal to the oro-facial level, as long as the critical regions of the hand and foot motor cortices remain intact. Accurate delineation of the anatomical lesion and functional areas using intra-operative neurophysiological monitoring is crucial for successful outcome of the surgery.

Original languageEnglish
Pages (from-to)479-484
Number of pages6
JournalEpileptic Disorders
Volume17
Issue number4
DOIs
Publication statusPublished - 2015 Dec

Keywords

  • Epilepsy surgery
  • Focal cortical dysplasia
  • Multimodal imaging
  • Primary motor cortex
  • Seizure outcome

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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