Focal cortical dysplasia

Case contributed by A.Prof Frank Gaillard

Presentation

Patient with intractable epilepsy.

Patient Data

Age: Young adult
Gender: Female
MRI

The cortex of the middle and inferior right temporal gyrus is abnormally thickened, with increased subjacent T2 signal in the white matter. The hippocampus is unremarkable in appearance. 

Pathology

The sections of temporal neocortex and white matter show foci of dyslamination in the middle temporal gyrus associated with fusion of contiguous molecular layers giving the appearances of localized polymicrogyria. Moderate numbers of large neurones are also noted in lamina I and there is disorientation of neurones within the middle laminae of the cortex. No balloon neurones are identified. Moderate numbers of mature neurones are seen in white matter. Myelination appears normal and there are no features of tumour. The features are of malformation of cortical development. The surgical margins are clear of the area of cortical dysplasia. 

NeuN = neuronal nuclear antigen

Histology courtesy of Michael Gonzales, Royal Melbourne Hospital.

Case Discussion

Transmantle sign is only rarely seen in Type I focal cortical dysplasia, and usually implies a Taylor type (Type II) malformation. 

PlayAdd to Share

Case information

rID: 6526
Case created: 7th Jul 2009
Last edited: 29th Feb 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.