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Radiofrequency thermocoagulation of the sulcus bottom in type II focal cortical dysplasia-related epilepsy with tapered implantation of electrodes: a case report

  • Case Report - Functional Neurosurgery - Epilepsy
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Abstract

We report a 15-year-old male patient with recurrent epileptic seizures for 12 years. Oral multiple drugs do not work well to his condition. MRI FLAIR scans revealed focal cortical dysplasia type II in the right parietal lobe. The diagnosis of the patient was drug-refractory epilepsy, FCD-related secondary epilepsy. According to the shape of the FCD lesion, electrodes were implanted in a tapered pattern along the bottom of the sulcus to completely destroy the focus. Magnetic resonance imaging at 6 months after surgery revealed that the FCD at the sulcus bottom was completely destroyed. After 26 months of follow-up, the patient had undergone no epileptic seizures, reaching Engel class I. For FCD that are located deep in the brain and adjacent to functional areas, craniotomy has a high risk. And stereoelectroencephalography-guided radiofrequency thermocoagulation may be a preferred treatment.

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Acknowledgements

We thank Bronwen Gardner, PhD, from LiwenBianji, Edanz Editing China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This project received funding from the “Cuiying Technology Innovation” clinical top-notch technology research of the Second Hospital of Lanzhou University (No. CY2018-BJ12) and the Higher Education Innovation Fund Project of Gansu Provincial (No. CY2019-BJ18).

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Authors and Affiliations

  1. Department of Functional Neurosurgery, Second Hospital of Lanzhou University, Lanzhou, China

    Han Yanming, Yang Wenzhen, Shen Yunjuan, Lan Zhengbo & Zhang Xinding

  2. Department of Neurophysiology, Second Hospital of Lanzhou University, Lanzhou, China

    Shi Zhe & Liu Yali

  3. Department of Epilepsy, Second Hospital of Lanzhou University, Lanzhou, China

    Wang Tiancheng

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  1. Han Yanming
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  2. Yang Wenzhen
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  3. Shen Yunjuan
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  4. Shi Zhe
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  5. Lan Zhengbo
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  7. Wang Tiancheng
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  8. Zhang Xinding
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Correspondence to Zhang Xinding.

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Comments

In this case report the authors describe the successful treatment of a 15-year-old male patient with an FCD-related secondary epilepsy with stereoelectroencephalography-guided radiofrequency thermocoagulation. In certain cases as here with the FCD located at the bottom of a sulcus and adjacent to a functional area, this can be an interesting alternative to open surgery. However the possibilities of this method are limited and the indication has to be critically discussed by an interdisciplinary team as described also in this case by the authors.

Peter Reinacher

Freiburg, Germany

This article is part of the Topical Collection on Functional Neurosurgery - Epilepsy

Han Yanming, and Yang Wenzhen are Co-first authors.

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Yanming, H., Wenzhen, Y., Yunjuan, S. et al. Radiofrequency thermocoagulation of the sulcus bottom in type II focal cortical dysplasia-related epilepsy with tapered implantation of electrodes: a case report. Acta Neurochir 163, 3045–3050 (2021). https://doi.org/10.1007/s00701-021-04998-7

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  • DOI: https://doi.org/10.1007/s00701-021-04998-7

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