“Mirror EPC”
Epilepsia partialis continua shifting sides after rolandic resection in dysplasia
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Abstract
Background: Epilepsia partialis continua (EPC) is a life-threatening condition often caused by focal cortical dysplasia (FCD). Resection of the motor cortex is contemplated in the hope that the trade-off between a severe motor deficit and complete seizure control justifies the procedure.
Methods: Report of 3 patients with EPC due to histologically confirmed FCD, who underwent resection of the motor cortex under acute electrocorticography.
Results: All had re-emergence of medically intractable EPC in the other side of the body after rolandic resection. Two patients died and the third continues with refractory attacks.
Conclusion: In some instances, EPC due to FCD may shift sides and re-emerge in the contralateral, previously asymptomatic, hemibody. A mechanism of disinhibition by surgery of a suppressed contralateral and homologous epileptogenic zone is speculated.
GLOSSARY
- ECoG=
- electrocorticography;
- EPC=
- epilepsia partialis continua;
- FCD=
- focal cortical dysplasia;
- RE=
- Rasmussen encephalitis
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received November 18, 2013.
- Accepted in final form July 16, 2014.
- © 2014 American Academy of Neurology
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