Temporal lobe focal cortical dysplasia: MRI imaging using FLAIR shows lesions consistent with neoplasia |
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Authors: | Ashok Modha Michael Vassilyadi Daniel Keene Carmencita Jimenez Jean Michaud Mary Ann Matzinger E C G Ventureyra |
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Institution: | (1) Division of Neurosurgery, Department of Surgery, Children’s Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada e-mail: ventureyra@cheo.on.ca Tel.: +1-613-7372316 Fax: +1-613-7384228, CA;(2) Division of Neurology, Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada, CA;(3) Department of Pathology, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada, CA;(4) Department of Radiology, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada, CA |
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Abstract: | Focal cortical dysplasia (FCD), a form of neuronal migration disorder, is a malformative lesion of the neocortex that occurs
during development of the brain. It can cause partial and generalized epilepsy. Seizures occur at an early age and are often
resistant to medication. Surgical resection has been found to be beneficial in these patients. Dual pathology, in the form
of mesial temporal sclerosis, has been associated with FCD. At the Children’s Hospital of Eastern Ontario, four patients with
temporal lobe FCD have re-cently, been identified. This paper discusses how these children presented and how they were managed,
with particular emphasis on their MRI findings and differential diagnoses. In three of the four patients neuroimaging studies
showed lesions consistent with a neoplastic process because of the large volume and mass effect. Radiologically, FCD may mimic
the MRI appearance of tumors, such as dysembryoplastic neuroepithelial tumors, primitive neuroectodermal tumors, gangliogliomas,
oligodendrogliomas, and astrocytomas. These lesions are best visualized on fluid-attenuated inversion recovery (FLAIR) imaging,
a technique that has recently become applicable in the clinical setting, as we help demonstrate in this series. With better
MRI capability, milder forms of FCD and microdysplasia may be distinguished.
Received: 7 September 1999 |
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Keywords: | Focal cortical dysplasia Temporal lobe epilepsy Mesial temporal sclerosis FLAIR imaging |
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