A 7-year-old boy with progressively worsening epilepsia partialis continua (EPC) involving the left side of the face was shown to have a small lesion in the right sensorimotor area. Facial twitches were sometimes but not always associated with spikes in the scalp EEG. At operation, electrocorticography (ECoG) showed seizure discharges at two electrodes in a grid with 1-cm spacing, at a site that coincided with the radiologic lesion and an area of abnormal pial vasculature. The gyral pattern suggested that this site was precentral, but cortical somatosensory evoked potential (SSEP) recordings and direct cortical stimulation demonstrated that it was postcentral and a limited resection was performed. The pathologic diagnosis was focal cortical dysplasia. Postoperatively, the child had no neurologic deficits, and seizure activity was reduced by more than 90%.
- Cortical stimulation
- Epilepsia partialis continua
- Focal cortical dysplasia
- Intraoperative neurophysiology
- Somatosensory evoked potentials
ASJC Scopus subject areas
- Clinical Neurology