Neurol India Close
 

Figure 2: A 11‑year‑old male child presented with left intraparietal cystic lesion and secondary generalized epilepsy for 2 years. AEDs did not satisfactorily control epilepsy. ECoG‑guided resection of epileptic foci and neighboring cortical thermocoagulation were performed with good outcome. This patient was seizure free for the 6‑year follow‑up period. (a) T2‑weighted MRI showed cystic lesion located in the left intraparietal lobe. (b) ECoG monitoring was performed before the cystic lesion was resected. (c) Epileptiform discharges were recorded before the cystic lesion was resected. (d) The apparent cystic wall was observed after the incision of the cortex. (e) Epileptiform discharges were recorded after the cystic lesion was totally resected; the location of the epileptic focus was reconfirmed by intraoperative ECoG monitoring. (f) Resection of epileptic focus guided by ECoG monitoring. (g) Epileptiform discharges were recorded again, but the frequency was significantly decreased. (h) Cortical thermocoagulation of residual epileptic foci was performed according to the ECoG monitoring findings, which indicated the presence of epileptic waveform discharges in the functional cortex. (i) No epileptic waveform discharges were detected by ECoG monitoring immediately after cortical thermocoagulation was performed. (j) The image after cystic lesion and epileptic foci were resected, and cortical thermocoagulation was performed. (k) Cystic lesion was arachnoid cyst and confirmed by pathological examination. (l) Glial proliferation and neuron degradation were found in the resected cerebral tissue, which was considered as the epileptic focus. (m) CT scan after 1‑year follow‑up

Figure 2: A 11‑year‑old male child presented with left intraparietal cystic lesion and secondary generalized epilepsy for 2 years. AEDs did not satisfactorily control epilepsy. ECoG‑guided resection of epileptic foci and neighboring cortical thermocoagulation were performed with good outcome. This patient was seizure free for the 6‑year follow‑up period. (a) T2‑weighted MRI showed cystic lesion located in the left intraparietal lobe. (b) ECoG monitoring was performed before the cystic lesion was resected. (c) Epileptiform discharges were recorded before the cystic lesion was resected. (d) The apparent cystic wall was observed after the incision of the cortex. (e) Epileptiform discharges were recorded after the cystic lesion was totally resected; the location of the epileptic focus was reconfirmed by intraoperative ECoG monitoring. (f) Resection of epileptic focus guided by ECoG monitoring. (g) Epileptiform discharges were recorded again, but the frequency was significantly decreased. (h) Cortical thermocoagulation of residual epileptic foci was performed according to the ECoG monitoring findings, which indicated the presence of epileptic waveform discharges in the functional cortex. (i) No epileptic waveform discharges were detected by ECoG monitoring immediately after cortical thermocoagulation was performed. (j) The image after cystic lesion and epileptic foci were resected, and cortical thermocoagulation was performed. (k) Cystic lesion was arachnoid cyst and confirmed by pathological examination. (l) Glial proliferation and neuron degradation were found in the resected cerebral tissue, which was considered as the epileptic focus. (m) CT scan after 1‑year follow‑up