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01-08-2019 | Epilepsy | Original Communication

Can histologically normal epileptogenic zone share common electrophysiological phenotypes with focal cortical dysplasia? SEEG-based study in MRI-negative epileptic patients

Authors: Stanislas Lagarde, Julia Scholly, Irina Popa, Maria Paola Valenti-Hirsch, Agnès Trebuchon, Aileen McGonigal, Mathieu Milh, Anke M. Staack, Béatrice Lannes, Benoît Lhermitte, François Proust, Mustapha Benmekhbi, Didier Scavarda, Romain Carron, Dominique Figarella-Branger, Edouard Hirsch, Fabrice Bartolomei

Published in: Journal of Neurology | Issue 8/2019

Abstract

Objective

We aimed to assess stereoelectroencephalography (SEEG) seizure-onset and interictal patterns associated with MRI-negative epilepsy and investigate their possible links with histology, extent of the epileptogenic zone (EZ) and surgical outcome.

Methods

We retrospectively analysed a cohort of 59 consecutive MRI-negative surgical candidates, who underwent SEEG recordings followed by cortectomy between 2000 and 2016.

Results

Most of the eight distinct seizure-onset patterns could be encountered both in confirmed focal cortical dysplasia (FCD) and in histologically non-specific or normal cases. We found strong correlation (p = 0.008) between seizure-onset pattern and histology for: (1) slow-wave/DC-shift prior to low voltage fast activity (LVFA), associated with normal/non-specific histology, and (2) bursts of polyspikes prior to LVFA, exclusively observed in FCD. Three interictal patterns were identified: periodic slow-wave/gamma burst, sub-continuous rhythmic spiking and irregular spikes. Both “periodic” patterns were more frequent in but not specific to FCD. Surgical outcome depended on the EZ complete removal, regardless electrophysiological features.

Conclusions

Histologically normal and FCD-associated epileptogenic zones share distinct interictal and ictal electrophysiological phenotypes, with common patterns between FCD subtypes and between dysplastic and apparently normal brain.

Significance

Some specific seizure-onset patterns seem to be predictive of the underlying histology and may help to detect an MRI-invisible FCD.

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Title: Can histologically normal epileptogenic zone share common electrophysiological phenotypes with focal cortical dysplasia? SEEG-based study in MRI-negative epileptic patients
Authors: Stanislas Lagarde
Julia Scholly
Irina Popa
Maria Paola Valenti-Hirsch
Agnès Trebuchon
Aileen McGonigal
Mathieu Milh
Anke M. Staack
Béatrice Lannes
Benoît Lhermitte
François Proust
Mustapha Benmekhbi
Didier Scavarda
Romain Carron
Dominique Figarella-Branger
Edouard Hirsch
Fabrice Bartolomei
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keyword: Epilepsy
Published in: Journal of Neurology / Issue 8/2019
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-019-09339-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Can histologically normal epileptogenic zone share common electrophysiological phenotypes with focal cortical dysplasia? SEEG-based study in MRI-negative epileptic patients

Abstract

Objective

Methods

Results

Conclusions

Significance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Significance

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