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Invasive EEG in Cortical Dysplasia 

Invasive EEG in Cortical Dysplasia
Invasive EEG in Cortical Dysplasia

Laura Tassi

, and Roberto Mai

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date: 15 July 2020

Focal cortical dysplasias (FCDs) are among the most frequent causes of focal, drug-resistant epilepsy. Recently, a new histopathological international consensus classification recognized three different types of FCDs, encompassing various anatomo-electro-clinical characteristics, associated with diverse connotations of architectural disruption and cytological abnormalities. These exhibit dissimilar patterns of clinical onset, seizure frequency, cognitive and neurological impairment, neuroradiological aspects, cortical localization, EEG characteristics, and surgical outcome. In the presurgical workup, the presence, localization, and possibility of identifying the limits of an anatomical lesion strongly influence the choice of investigations. Consequently, in FCDs type II and III, in which the dysplasia (particularly in type IIb) or the associated lesion (type III) are unambiguously evident, invasive monitoring is not mandatory. In contrast, FCDs type I, and a fraction of type II (varying between from 10% to 50%) show no or minor abnormalities on neuroradiological investigations. Here, invasive recordings are usually necessary.

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