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Chapitre D'ouvrage Année : 2018

SEEG in Polymicrogyria: When and How?

Résumé

Polymicrogyria (PMG) is one of the most common malformations of cortical development (MCDs), with epilepsy affecting most patients. PMG-related drug-resistant epilepsy patients can be considered for surgery in well-selected cases. In this context, a comprehensive presurgical evaluation, often including stereo electroencephalography, is warranted to accurately delineate the epileptogenic zone. The heterogeneity of intrinsic epileptogenicity in the PMG, together with the additional or predominant involvement of remote cortical areas, calls for a different strategy in PMG compared with other MCDs, one that is not predominantly MRI- but rather SEEG-oriented. Favourable results in terms of seizure freedom and antiepileptic drug cessation are feasible in a large proportion of patients with unilateral PMG. PMG extent should not exclude the possibility of epilepsy surgery. On the other hand, patients with hemispheric PMG can be excellent hemispherotomy candidates, particularly in the presence of contralateral hemiparesis. Recent findings support early consideration of surgery in PMG-related drug-resistant epilepsy.
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Dates et versions

hal-03029918 , version 1 (29-11-2020)

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Louis Maillard, Georgia Ramantani. SEEG in Polymicrogyria: When and How?. Lhatoo, Samden D. and Kahane, Philippe and Lüders, Hans O. Invasive Studies of the Human Epileptic Brain: Principles and Practice, Part 2, Chapter 19, Oxford University Press, pp.246-262, 2018, 9780198714668. ⟨10.1093/med/9780198714668.003.0019⟩. ⟨hal-03029918⟩
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