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Pre-Op MRI (Axial FSE T2W) Right Fronto -lateral dysplasia(arrow).
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MRI Brain 1.5 T (Jul 2014) showed high signal abnormality within the subcortical white matter, and grey matter of the right frontal lobe appeared unchanged when compared to the report of MRI 2003 and likely representing a focus of gliosis or cortical dysplasia (Fig. 1A). Post-op imaging shows complete lesion removal (Fig. 1B).
Post-Op MRI (A)Axial and Coronal FSE T2 W).
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The EEG signature in each case showed a right anterior quadrant onset, suggestive of a right frontal signature (Fig. 2).
All seizures showed a stereotypical right anterior onset, with first visible change being irregular slowing in the right frontotemporal region (highlighted) before evolving rhythmically over the same areas.
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Histopathology analysis reported the resected specimen with architectural abnormalities, dysmorphic neurones and balloon cells representing those of a Cortical Dysplasia Palmini Type 2B (Fig. 3).
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