Turkish Neurosurgery 2022 , Vol 32 , Num 5
An Investigation into the Correlation of Scalp Electrophysiological Findings with Preoperative Clinical and Imaging Findings in Patients with Focal Cortical Dysplasia
Zahide MAIL GURKAN1,Ozge KAPAR2,Seher Naz YENI3,Bilge BILGIC2,Candan GURSES4
1Istanbul University, Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul, Turkey
2Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Istanbul, Turkey
3Istanbul University-Cerrahpasa, School of Medicine, Department of Neurology, Istanbul, Turkey
4Koc University, Department of Neurology, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.36547-21.2 AIM: To evaluate the patients who had epilepsy surgery and pathologically proven focal cortical dysplasia (FCD) in order to further classify and discuss electroencephalography (EEG) findings in different pathological subtypes.

MATERIAL and METHODS: This study included 19 refractory epilepsy patients who underwent surgery between 1999 and 2017 in the Istanbul Faculty of Medicine. Demographic data, preoperative examinations, scalp video EEGs, and postoperative outcomes were evaluated retrospectively.

RESULTS: In this study, 36.8% of the patients were female. The mean age was 21.89 ± 14.64 years. Rhythmic epileptiform discharges (RED) were observed in 31.6%. 37.5% of the patients with isolated intermittent spike/sharp waves were type I, 50% were type II, and 12.5% were type III. 100% of the patients with normal background activity were FCD type II. 67% of the patients with asymmetric slowing were FCD type I, 22% was FCD type II, 11% were FCD type III. 71% of the patients with symmetrical slowing were FCD type I, 29% were FCD type II. One patient had Frontal Intermittent Rhythmic Activity, one patient had Electrical Status Epilepticus in Slow Sleep, two patients had "burst suppression," and one patient had a "switch of" sign. The frequency of focal epileptogenic activity was higher when there was an FCD lesion on magnetic resonance imaging.

CONCLUSION: The findings obtained in this study did not reveal any distinctive electrophysiological features in FCD and subgroups of FCD. The incidence of REDs did not differ between types. The frequency of isolated intermittent sharp/spike waves was higher in type II than I. Intermittent and continuous EEG slowing was more commonly seen among FCD Type I patients. Keywords : Focal cortical dysplasia, Epilepsy surgery, Scalp EEG, Pathological subtypes, Rhythmic epileptiform discharges

Corresponding author : Zahide MAIL GURKAN, zahidemailgurkan@gmail.com