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Nichtinvasive Charakterisierung der FCD II-assoziierten Epilepsie

Non-invasive characterization of FCD II-associated epilepsy

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Zusammenfassung

Die fokale kortikale Dysplasie (FCD), d. h. die FCD Typ II nach aktueller Klassifikation bzw. „Taylor-Dysplasie“, ist eine sehr relevante und interessante ätiologische Läsion bei pharmakoresistenter fokaler Epilepsie, auch im Erwachsenenalter. Eine FCD II bildgebend zu detektieren und die assoziierte epileptogene Zone zu definieren ist eine diagnostische Herausforderung. Viele FCD II werden im nicht spezialisierten Setting nicht erkannt, viele Aspekte der FCD II-assoziierten Epilepsie sind komplex. Wir geben hier einen Überblick über Erfahrungen in der prächirurgischen Diagnostik der Epilepsie bei FCD II mit besonderem Schwerpunkt auf nichtinvasive Merkmale der Epileptogenität inklusive Würdigung der Magnetenzephalographie. Außerdem umreißen wir Optionen in Richtung weniger invasiver Abklärung auf dem Weg zu einem erfolgreichen epilepsiechirurgischen Eingriff bei FCD II.

Abstract

Focal cortical dysplasia (FCD), i. e. FCD type II according to current classification or Taylor type dysplasia, is a very relevant and interesting etiological lesion in pharmacoresistant focal epilepsy, also in adults. Detecting FCD II on imaging as well as defining the associated epileptogenic zone is a diagnostic challenge, as many FCDs are not recognized during non-specialist assessment and many aspects of FCD-related epilepsy are complex. In this article we give a review of experiences with presurgical diagnostics in FCD II-related epilepsy, its clinical characteristics and diagnostic appearance, with an emphasis on non-invasive markers of epileptogenicity, including an appraisal of magnetoencephalography (MEG). We outline the options for achieving a less invasive work-up on the way towards successful epilepsy surgery in FCD II.

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  1. Epilepsiezentrum Erlangen, Neurologische Klinik, Universität Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland

    Burkhard S. Kasper &  Stefan Rampp

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  1. Burkhard S. Kasper
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B.S. Kasper und S. Rampp geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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Kasper, B.S., Rampp, S. Nichtinvasive Charakterisierung der FCD II-assoziierten Epilepsie. Z. Epileptol. 30, 113–121 (2017). https://doi.org/10.1007/s10309-016-0084-z

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