Life-Threatening Focal Status Epilepticus Due to Occult Cortical Dysplasia

Simon Harvey, Richard Desbiens, François Dubeau, Frederick Andermann, François Leproux, Denis Melanson, Yvon Robitaille, André Olivier, Samuel F. Berkovic, Renate Kalnins, Gavin Fabinyi, Kenneth D. Laxer, Nicholas M. Barbaro

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

Neuronal migration disorders are usually, but not necessarily, demonstrated by magnetic resonance imaging. Preoperative suspicion of these anomalies in the presence of normal magnetic resonance studies has important practical implications. This study delineates some clinical features that permit early suspicion of focal cortical dysplasia localized in the central and precentral regions. —In a retrospective case series, we studied the clinical presentation of four consecutive patients with normal preoperative magnetic resonance images in whom focal cortical dysplasia was found in the surgical specimen. —Patients were seen in three referral centers specializing in epilepsy surgery. —Four patients (three female), between the ages of 4 and 21 years, had intractable partial seizures leading to resective brain surgery. —Three patients had corticectomies in the central (two patients) or frontal (one patient) regions. One underwent an en bloc resection of the central area after two unsuccessful corticectomies and cortical transcetion. —Three patients presented with life-threatening focal motor status epilepticus necessitating intubation, and one had epilepsia partialis continua. All had had seizures previously, and the attacks progressed to intractability after 1½ to 3 years. Surgery led to control of the seizures, but only two patients became seizure free (mean follow-up, 15.7 months). All but one developed a postoperative deficit, which eventually improved. —Focal cortical dysplasia should be suspected when life-threatening focal motor status epilepticus or epilepsia partialis continua occur in children or young persons without another obvious cause. Normal magnetic resonance studies do not exclude neuronal migration disorders.

Original languageEnglish (US)
Pages (from-to)695-700
Number of pages6
JournalArchives of Neurology
Volume50
Issue number7
DOIs
StatePublished - 1993
Externally publishedYes

Fingerprint

Malformations of Cortical Development
Status Epilepticus
Seizures
Epilepsia Partialis Continua
Group II Malformations of Cortical Development
Magnetic Resonance Spectroscopy
Intubation
Epilepsy
Referral and Consultation
Magnetic Resonance Imaging
Brain

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology
  • Neuroscience(all)

Cite this

Harvey, S., Desbiens, R., Dubeau, F., Andermann, F., Leproux, F., Melanson, D., ... Barbaro, N. M. (1993). Life-Threatening Focal Status Epilepticus Due to Occult Cortical Dysplasia. Archives of Neurology, 50(7), 695-700. https://doi.org/10.1001/archneur.1993.00540070015007

Life-Threatening Focal Status Epilepticus Due to Occult Cortical Dysplasia. / Harvey, Simon; Desbiens, Richard; Dubeau, François; Andermann, Frederick; Leproux, François; Melanson, Denis; Robitaille, Yvon; Olivier, André; Berkovic, Samuel F.; Kalnins, Renate; Fabinyi, Gavin; Laxer, Kenneth D.; Barbaro, Nicholas M.

In: Archives of Neurology, Vol. 50, No. 7, 1993, p. 695-700.

Research output: Contribution to journalArticle

Harvey, S, Desbiens, R, Dubeau, F, Andermann, F, Leproux, F, Melanson, D, Robitaille, Y, Olivier, A, Berkovic, SF, Kalnins, R, Fabinyi, G, Laxer, KD & Barbaro, NM 1993, 'Life-Threatening Focal Status Epilepticus Due to Occult Cortical Dysplasia', Archives of Neurology, vol. 50, no. 7, pp. 695-700. https://doi.org/10.1001/archneur.1993.00540070015007
Harvey S, Desbiens R, Dubeau F, Andermann F, Leproux F, Melanson D et al. Life-Threatening Focal Status Epilepticus Due to Occult Cortical Dysplasia. Archives of Neurology. 1993;50(7):695-700. https://doi.org/10.1001/archneur.1993.00540070015007
Harvey, Simon ; Desbiens, Richard ; Dubeau, François ; Andermann, Frederick ; Leproux, François ; Melanson, Denis ; Robitaille, Yvon ; Olivier, André ; Berkovic, Samuel F. ; Kalnins, Renate ; Fabinyi, Gavin ; Laxer, Kenneth D. ; Barbaro, Nicholas M. / Life-Threatening Focal Status Epilepticus Due to Occult Cortical Dysplasia. In: Archives of Neurology. 1993 ; Vol. 50, No. 7. pp. 695-700.
@article{7d9b4c4e9059420a94614e99dc1fc01e,
title = "Life-Threatening Focal Status Epilepticus Due to Occult Cortical Dysplasia",
abstract = "Neuronal migration disorders are usually, but not necessarily, demonstrated by magnetic resonance imaging. Preoperative suspicion of these anomalies in the presence of normal magnetic resonance studies has important practical implications. This study delineates some clinical features that permit early suspicion of focal cortical dysplasia localized in the central and precentral regions. —In a retrospective case series, we studied the clinical presentation of four consecutive patients with normal preoperative magnetic resonance images in whom focal cortical dysplasia was found in the surgical specimen. —Patients were seen in three referral centers specializing in epilepsy surgery. —Four patients (three female), between the ages of 4 and 21 years, had intractable partial seizures leading to resective brain surgery. —Three patients had corticectomies in the central (two patients) or frontal (one patient) regions. One underwent an en bloc resection of the central area after two unsuccessful corticectomies and cortical transcetion. —Three patients presented with life-threatening focal motor status epilepticus necessitating intubation, and one had epilepsia partialis continua. All had had seizures previously, and the attacks progressed to intractability after 1½ to 3 years. Surgery led to control of the seizures, but only two patients became seizure free (mean follow-up, 15.7 months). All but one developed a postoperative deficit, which eventually improved. —Focal cortical dysplasia should be suspected when life-threatening focal motor status epilepticus or epilepsia partialis continua occur in children or young persons without another obvious cause. Normal magnetic resonance studies do not exclude neuronal migration disorders.",
author = "Simon Harvey and Richard Desbiens and Fran{\cc}ois Dubeau and Frederick Andermann and Fran{\cc}ois Leproux and Denis Melanson and Yvon Robitaille and Andr{\'e} Olivier and Berkovic, {Samuel F.} and Renate Kalnins and Gavin Fabinyi and Laxer, {Kenneth D.} and Barbaro, {Nicholas M.}",
year = "1993",
doi = "10.1001/archneur.1993.00540070015007",
language = "English (US)",
volume = "50",
pages = "695--700",
journal = "Archives of Neurology",
issn = "0003-9942",
publisher = "American Medical Association",
number = "7",

}

TY - JOUR

T1 - Life-Threatening Focal Status Epilepticus Due to Occult Cortical Dysplasia

AU - Harvey, Simon

AU - Desbiens, Richard

AU - Dubeau, François

AU - Andermann, Frederick

AU - Leproux, François

AU - Melanson, Denis

AU - Robitaille, Yvon

AU - Olivier, André

AU - Berkovic, Samuel F.

AU - Kalnins, Renate

AU - Fabinyi, Gavin

AU - Laxer, Kenneth D.

AU - Barbaro, Nicholas M.

PY - 1993

Y1 - 1993

N2 - Neuronal migration disorders are usually, but not necessarily, demonstrated by magnetic resonance imaging. Preoperative suspicion of these anomalies in the presence of normal magnetic resonance studies has important practical implications. This study delineates some clinical features that permit early suspicion of focal cortical dysplasia localized in the central and precentral regions. —In a retrospective case series, we studied the clinical presentation of four consecutive patients with normal preoperative magnetic resonance images in whom focal cortical dysplasia was found in the surgical specimen. —Patients were seen in three referral centers specializing in epilepsy surgery. —Four patients (three female), between the ages of 4 and 21 years, had intractable partial seizures leading to resective brain surgery. —Three patients had corticectomies in the central (two patients) or frontal (one patient) regions. One underwent an en bloc resection of the central area after two unsuccessful corticectomies and cortical transcetion. —Three patients presented with life-threatening focal motor status epilepticus necessitating intubation, and one had epilepsia partialis continua. All had had seizures previously, and the attacks progressed to intractability after 1½ to 3 years. Surgery led to control of the seizures, but only two patients became seizure free (mean follow-up, 15.7 months). All but one developed a postoperative deficit, which eventually improved. —Focal cortical dysplasia should be suspected when life-threatening focal motor status epilepticus or epilepsia partialis continua occur in children or young persons without another obvious cause. Normal magnetic resonance studies do not exclude neuronal migration disorders.

AB - Neuronal migration disorders are usually, but not necessarily, demonstrated by magnetic resonance imaging. Preoperative suspicion of these anomalies in the presence of normal magnetic resonance studies has important practical implications. This study delineates some clinical features that permit early suspicion of focal cortical dysplasia localized in the central and precentral regions. —In a retrospective case series, we studied the clinical presentation of four consecutive patients with normal preoperative magnetic resonance images in whom focal cortical dysplasia was found in the surgical specimen. —Patients were seen in three referral centers specializing in epilepsy surgery. —Four patients (three female), between the ages of 4 and 21 years, had intractable partial seizures leading to resective brain surgery. —Three patients had corticectomies in the central (two patients) or frontal (one patient) regions. One underwent an en bloc resection of the central area after two unsuccessful corticectomies and cortical transcetion. —Three patients presented with life-threatening focal motor status epilepticus necessitating intubation, and one had epilepsia partialis continua. All had had seizures previously, and the attacks progressed to intractability after 1½ to 3 years. Surgery led to control of the seizures, but only two patients became seizure free (mean follow-up, 15.7 months). All but one developed a postoperative deficit, which eventually improved. —Focal cortical dysplasia should be suspected when life-threatening focal motor status epilepticus or epilepsia partialis continua occur in children or young persons without another obvious cause. Normal magnetic resonance studies do not exclude neuronal migration disorders.

UR - http://www.scopus.com/inward/record.url?scp=0027194158&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027194158&partnerID=8YFLogxK

U2 - 10.1001/archneur.1993.00540070015007

DO - 10.1001/archneur.1993.00540070015007

M3 - Article

C2 - 8323470

AN - SCOPUS:0027194158

VL - 50

SP - 695

EP - 700

JO - Archives of Neurology

JF - Archives of Neurology

SN - 0003-9942

IS - 7

ER -