Electroclinical and magnetoencephalographic analysis of epilepsy in patients with congenital bilateral perisylvian syndrome.

Abstract

PURPOSE:

Epilepsies in four patients with congenital bilateral perisylvian syndrome (CBPS) were studied electroclinically and by magnetoencephalography (MEG) to determine whether cortical dysplasia associated with this syndrome is epileptogenic.

METHODS:

We studied three women and one man (mean +/- SD age 30.8 +/- 3.4 years) with a diagnosis of CBPS based on magnetic resonance imaging (MRI). All had drug-resistant epilepsy. In addition to electroclinical analysis, the distribution of equivalent-current dipoles (ECDs) analyzed from MEG signals was examined.

RESULTS:

Patient 1 had left-sided parietal lobe epilepsy and ECDs clustered in the left temporoparietal lobe. Patient 2 had bilateral, independent temporoparietal lobe epilepsy, and ECDs were found in both hemispheres, with clustering in the right temporoparietal lobe but not in the left hemisphere. Patient 3 presumably had parietal lobe epilepsy with unidentified focus side and ECDs clustered in the left parietal and right temporal lobes. Patient 4 had symptomatic generalized epilepsy, and ECDs were observed in both hemispheres without clustering. In the three patients who had partial epilepsy (patients 1-3), clusters of ECDs overlaid the perisylvian dysplasia and were not found elsewhere.

CONCLUSIONS:

Patients with CBPS may have either symptomatic partial epilepsy or symptomatic generalized epilepsy, and those with partial epilepsy are likely to have temporoparietal foci. In addition, cortical dysplasia is closely related to the generation of partial seizures and may be epileptogenic per se. However, this study did not elucidate the relationship between cortical dysplasia and CBPS-generated generalized epilepsy.

• Authors: M Tanaka, K Yamada, Y Watanabe, K Matsuda, Y Inoue, T Fujiwara, K Yagi
• Journal: Epilepsia (Epilepsia) Vol. 41 Issue 12 Pg. 1584-91 (Dec 2000) ISSN: 0013-9580 [Print] United States
• PMID: 11114217 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Cerebral Cortex (abnormalities, physiopathology)
• Electroencephalography (statistics & numerical data)
• Epilepsy (diagnosis, physiopathology)
• Female
• Functional Laterality (physiology)
• Humans
• Magnetic Resonance Imaging (statistics & numerical data)
• Magnetoencephalography (statistics & numerical data)
• Male
• Syndrome