Article
Cortical dysplasia:Clinical work-up and neuropathological findings in a drug resistant epilepsy case.
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Published: | September 11, 2012 |
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22 year old male with record of premature membrane rupture birth, obtained by caesarean operation due to fetal distress, mild traumatic brain injury at the age of 7 and poor school performance. At the age of 8 starts with simple partial motor seizures of the right arm that progress to generalized myoclonic seizures, treated with oxcarbazepine 600mgt.i.d.and levetiracetam 500 mg q.d. showing bad response to treatment. EEG report focal mild dysfunction in left temporal and occipital areas. MRI shows dysplasia in temporal and parietal areas with hypointensity on T1 secuence, and hyperintensity on T2 weighted and FLAIR images and polymicrogyric patterns. He was submitted to surgical section of the left parietal cortex; the histopathological study reveals hypoxic areas, difuse microinfarctions, engrossment of the cortical region with eosinophylic neurons, vacuolated neuropil and slight gliosis. After surgery he persists with partial sensitive crisis of the right arm wich had remitted with oxcarbazepine 600 mg b.i.d. and levetiracetam 500 mg b.i.d. Currently the patient has a satisfactory evolution with no seizures or any neurological focal signs.