Clinical Features of Unilateral Polymicrogyria and Epilepsy in Adults.
Abstract number :
G.05
Submission category :
Year :
2001
Submission ID :
2763
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
E.A. Passaro, MD, Neurology, University of Michigan, Ann Arbor, MI; C. Milling, MD, Neurology, University of Michigan, Ann Arbor, MI; D.M. Gomez-Hassan, MD, PhD, Radiology, University of Michigan, Ann Arbor, MI; D. Minecan, MD, Neurology, University of Mi
RATIONALE: Polymicrogyria (PMG)is a malformation of cortical development due to neurons which migrate to the cortex, but fail to organize normally. It consists of multiple small gyri which on MRI may appear as flattened cortex. PMG may be focal, mutli-lobar, bilateral or generalized. We studied the clinical, EEG and MRI features of adult patients with polymicrogyria and epilepsy.
METHODS: In the University of Michigan database, we identified 8 patients with unilateral PMG defined as PMG involving two or more lobes.
MRI consisted of T1 weighted SPGR 1.5mm slices and FLAIR sequences on all patients. The following features were studied: age of onset, neurologic deficit, intelligence, early risk factors, type of epilepsy, medical intractibility, inter-ictal EEG, video-EEG when available and MRI features.
RESULTS: Polymicrogryia involved the fronto-parietal region in two cases, the fronto-temporal-parietal region in 3 cases, the fronto-temporal region in 2 cases and the parieto-occipital region in one case. 6/8 patients had ipsilateral hippocampal atrophy. Age of onset was between 11-24 in 7/8 cases and at age 4 in one case. 7/8 had mild unilateral weakness, intelligence was normal in 6/8 cases and mild mental retardation was present in 2/8 cases.
All patients had partial onset seizures with 7/8 medically intractable. 7/8 patients had an aura. Inter-ictal EEG showed anterior temporal spikes; fronto-temporal spikes, central-temporal spikes.
CONCLUSIONS: Unilateral PMG and epilepsy in adults is associated with adolescent or adult onset partial epilepsy, normal intelligence in most patients, mild unilateral weakness and dual pathology (mesial temporal atrophy)in some cases.