Focal cortical dysplasia (FCD) is a common cause of intractable epilepsy that is surgically curable. MRI findings of FCD can be obvious (type II) or subtle (type I). Presurgical assessment of FCD requires detailed neurophysiological and functional assessment.The aims of this exhibit are: To review characteristic MRI findings of FCD To learn functional anatomy and modality of choice required for presurgical assessment of FCD treatment planning.
TABLE OF CONTENTS/OUTLINEA. Anatomy Gyration anomaly related to FCD Find asymmetric gyration and look for FCD at the depth of sulcus Cerebrospinal fluid cleft with cortical dimpl Power button sign of FCD in the central region: differential point from normal variation of the central sulcus Pitfall: subclinical abnormal gyration pattern Clinical semiology and location of the lesion Visual hallucination, auditory aura, fear, lip smacking, motor component, humming, etc. 3. Presurgical Assessment Neuropsychological testing, functional MRI (Language, memory) and Wada test What need to know when FCD is located in eloquent cortex. B. Clinical cases Motor cortex FCD and how to approach Language zone FCD and example of fMRI language