Voxel-based morphometric MRI post-processing in MRI-negative focal cortical dysplasia followed by simultaneously recorded MEG and stereo-EEG

Z. I. Wang, S. E. Jones, A. J. Ristic, C. Wong, Y. Kakisaka, K. Jin, F. Schneider, J. A. Gonzalez-Martinez, J. C. Mosher, D. Nair, R. C. Burgess, I. M. Najm, A. V. Alexopoulos

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

We aim to report on the usefulness of a voxel-based morphometric MRI post-processing technique in detecting subtle epileptogenic structural lesions. The MRI post-processing technique was implemented in a morphometric analysis program (MAP), in a 30-year-old male with pharmacoresistant focal epilepsy and negative MRI. MAP gray-white matter junction file facilitated the identification of a suspicious structural lesion in the right frontal opercular area. The electrophysiological data by simultaneously recorded stereo-EEG and MEG confirmed the epileptogenicity of the underlying subtle structural abnormality. The patient underwent a limited right frontal opercular resection, which completely included the area detected by MAP. Surgical pathology revealed focal cortical dysplasia (FCD) type IIb. Postoperatively the patient has been seizure-free for 2 years. This study demonstrates that MAP has promise in increasing the diagnostic yield of MRI reading in challenging patients with "non-lesional" MRIs. The clinical relevance and epileptogenicity of MAP abnormalities in patients with epilepsy have not been investigated systematically; therefore it is important to confirm their pertinence by performing electrophysiological recordings. When confirmed to be epileptogenic, such MAP abnormalities may reflect an underlying subtle cortical dysplasia whose complete resection can lead to seizure-free outcome.

Original languageEnglish
Pages (from-to)188-193
Number of pages6
JournalEpilepsy Research
Volume100
Issue number1-2
DOIs
Publication statusPublished - 2012 Jun

Keywords

  • Epilepsy
  • Focal cortical dysplasia
  • MEG
  • MRI-negative
  • Magnetoencephalography
  • Stereo-EEG
  • Voxel-based morphometric MRI post-processing

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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