The epileptogenic zone in children with tuberous sclerosis complex is characterized by prominent features of focal cortical dysplasia
| Autor: | Petr Jezdik, Maarten H. Lequin, Floor E. Jansen, Barbora Benova, Martin Kyncl, Hanna M. Hulshof, Kees P.J. Braun, Anezka Belohlavkova, Pavel Krsek |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pathology
medicine.medical_specialty tuberous sclerosis complex Combinatorial analysis Tuberous sclerosis Epilepsy Tuberous Sclerosis medicine Humans magnetic resonance imaging Epilepsy surgery Child RC346-429 medicine.diagnostic_test business.industry Brain Magnetic resonance imaging Cortical dysplasia medicine.disease Epileptogenic zone Malformations of Cortical Development Neurology Feature (computer vision) epilepsy surgery Neurology (clinical) pre‐surgical evaluation Neurology. Diseases of the nervous system business focal cortical dysplasia |
| Zdroj: | Epilepsia Open, Vol 6, Iss 4, Pp 663-671 (2021) |
| ISSN: | 2470-9239 |
| Popis: | Objective Patients with tuberous sclerosis complex (TSC) present with drug‐resistant epilepsy in about 60% of cases, and evaluation for epilepsy surgery may be warranted. Correct delineation of the epileptogenic zone (EZ) among multiple dysplastic lesions on MRI represents a challenging step in pre‐surgical evaluation. Methods Two experienced neuroradiologists evaluated pre‐ and post‐surgical MRIs of 28 epilepsy surgery patients with TSC, assessing characteristics of tubers, cysts, calcifications, and focal cortical dysplasia (FCD)—resembling lesions. Utilizing multiple metrics, we compared MRI features of the EZ—defined as the resected area in TSC patients who achieved seizure‐freedom 2 years after epilepsy surgery—with features of other brain areas. Using combinatorial analysis, we identified combinations of dysplastic features that are most frequently observed in the epileptogenic zone in TSC patients. Results All TSC‐associated dysplastic features were more frequently observed in the EZ than in other brain areas (increased cortical thickness, gray‐white matter blurring, transmantle sign, calcifications, and tubers; Kendal's tau 0.35, 0.25, 0.27, 0.26, and 0.23, respectively; P value |
| Databáze: | OpenAIRE |
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