Parallels in lignin biosynthesis

Abstract

Patients with malformations of cortical development often suffer fromintractable focal epilepsy. This review considers recent progressin the selection and seizure outcome of patients undergoing resectiveepilepsy surgery for this condition.Patients with malformations ofcortical development restricted to part or even a whole hemispheremay be candidates for epilepsy surgery even when, due to microscopicmalformations, magnetic resonance imaging shows no detectable lesion.Despite recent advances in structural and functional imaging, themajority of patients with this condition undergo invasive evaluation.Patients with focal cortical dysplasia, with and without a detectablelesion on magnetic resonance imaging, often have a favorable outcomewith epilepsy surgery. The underlying pathological substrate seemsto be a better predictor for surgical outcome in patients with focalcortical dysplasia than the presence of a lesion on magnetic resonanceimaging. Epilepsy surgery can be offered in a highly selected subgroupof patients with unilateral nodular heterotopia. Seizures in hemimegalencephalymay respond favorably to hemispherectomy, although most childrenwill continue to have seizures and significant functional impairments.Patientswith focal epilepsy due to malformations of cortical developmentare often intractable to medical management. Resective epilepsy surgerycan be beneficial, particularly for patients with focal corticaldysplasia and unilateral hemispheric malformations.