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November 2, 2015: Focal cortical dysplasia

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November 2, 2015

Focal cortical dysplasia

Focal cortical dysplasia, or FCD, is a neuronal migration disorder typically presenting with epilepsy in children and adults. The seizures are often pharmacoresistant, and surgical resection of the epileptigenic zone is a treatment option with success in some patients. Classification is based on histological findings, including cytoarchitectural disorganization, dysmorphic neurons and balloon cells. FCD can occur in any part of the cerebral cortex or within sulci, and it can be isolated or occur with other lesions. High-resolution MRI findings include cortical thickening, signal intensity changes, gray-white matter junction blurring, and the transmantle sign showing subcortical hyperintensity tapering down to ventricle.

  1. Blümcke I, Thom M, Aronica E, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia 2011; 52: 158-174.
  2. Miller JW, Gonzalez-Martinez J. Epilepsy and the funny sulcus. Neurology 2015; 84: 2012-2013.

Submitted by Mirret El-Hagrassy, MD, Clinical Neurophysiology/EEG/Epilepsy Fellow, PGY5, Cleveland Clinic, Cleveland, OH.

Disclosures: Dr. El-Hagrassy reports no disclosures.

For more clinical pearls and other articles of interest to neurology trainees, visit Neurology. Listen to this week's Neurology Podcast.

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