Focal cortical dysplasia - bottom of sulcus

Case Discussion

The patient went on to have epilepsy surgery. Histopathology of the resected lesion as follows: "MICROSCOPIC DESCRIPTION Sections show portions of cerebral cortex demonstrating dyslamination and frequent dysmorphic neurons with abnormally distributed Nissl substance, vacuolated cytoplasm and enlarged nuclei. Occasional balloon cells are present with glassy eosinophilic cytoplasm. There is background reactive astrocytosis. A few heterotopic white matter neurons are seen. There is no evidence of a neoplastic process. On immunohistochemistry, maloriented/dysmorphic neurons are highlighted with NeuN, NF and synaptophysin. Reactive astrocytosis is highlighted with GFAP. The ballooned cells are positive for GFAP, NF and synaptophysin. CONCLUSION Right parietal tissue - focal cortical dysplasia, type IIb." The patient remains seizure free at last follow-up.