Brief potentially ictal rhythmic discharges on intraoperative electrocorticography predict a good outcome of focal cortical dysplasia after surgical resection: a case report  

作　　者：Sofía S.Sánchez‑Boluarte Wilfor Aguirre‑Quispe Manuel Herrera Aramburú William O.Tatum Walter De La Cruz Ramírez 

机构地区：[1]School of Medicine,Cesar Vallejo University,Av.Victor Larco,Trujillo,Trujillo 1770,Peru [2]Departamento de Epilepsia,Instituto Nacional de Ciencias Neurológicas,Jr.Ancash 1271,Lima,Lima 15001,Peru [3]Neurosciences,Clinical Effectiveness and Public Health Research Group,Universidad Científica del Sur,Panamericana Sur 19,Villa EL Salvador,Lima,Lima 15067,Peru [4]Department of Neurology,Mayo Clinic,Mangurian Bldg.,Fourth Floor,4500 San Pablo Road,FL 32224 Jacksonville,USA

出　　处：《Acta Epileptologica》2023年第3期163-167,共5页癫痫学报（英文）

摘　　要：Background Focal cortical dysplasia(FCD)is a common cause of drug-resistant epilepsy.Electroencephalography(EEG)biomarkers that predict good postoperative outcomes are essential for identifying patients with focal epilepsies.Case presentation We report the case of a 21-year-old female with seizure onset at the age of 9,characterized by left-hand dystonic posturing and impaired awareness,which evolved to bilateral tonic-clonic seizures,evaluated in a neurological referral center in Lima,Peru.During 6-h video-EEG,interictal EEG revealing focal brief potentially ictal rhythmic discharges(BIRDs)over the right frontal central region,lasting less than 10 s.The ictal features were characterized by low-voltage fast activity over the same area.Brain magnetic resonance imaging(MRI)demonstrated a focal lesion of focal cortical dysplasia type II in the right frontal lobe.The patient underwent a lesionectomy guided by electrocorticography,which showed continuous polyspikes.BIRDs showing a brief burst of spikes lasting longer than 0.5 s,were also identified on intraoperative electrocorticography(ECoG)and helped define the extent of resection.The patient obtained an Engel Outcome Class IA at 6 years of follow-up.Conclusions The atypical BIRDs on ECoG can be used as a prognostic biomarker for prolonged seizure-freedom outcome in patients with epilepsy.Additional reports are needed in developing countries with and without brain MRI lesions to advance outpatient presurgical evaluations despite limited resources.

关 键 词：ELECTROCORTICOGRAPHY Cortical dysplasia-focal epilepsy syndrome Drug-resistant epilepsy Frontal lobe epilepsy 

分 类 号：R742.1[医药卫生—神经病学与精神病学]