A surgical case of complete resection of the focal cortical and subcortical dysplasia in the motor cortex: Case report.

Abstract

Focal cortical dysplasias (FCD) are highly epileptogenic and are frequently associated with medically refractory focal epilepsy. FCD are frequently located in the frontal lobe rendering its complete resection highly challenging when in proximity to the motor cortex. We report the case of a 25-year-old woman with medically refractory epilepsy secondary to a focal cortical dysplasia in the motor cortex and extending deeply into the subcortical white matter. A detailed presurgical evaluation and invasive EEG monitoring performed at our epilepsy monitoring unit along with the use of motor mapping, functional MRI, diffusion tensor imaging and Stealth navigation system resulted in the complete resection of the lesion without permanent postoperative motor deficit. The patient remained seizure free at 63 months follow-up, while maintained on a single antiepileptic drug.