Familial temporal lobe epilepsy due to focal cortical dysplasia type IIIa. (September 2015)

• Record Type: Journal Article
• Authors: Fabera, Petr; Krijtova, Hana; Tomasek, Martin; Krysl, David; Zamecnik, Josef; Mohapl, Milan; Jiruska, Premysl; Marusic, Petr
• Is Part Of: Seizure. Volume 31(2015)
• Page Start: 120
• Page End: 123
• Publication Date: 2015-09
• Subjects: Familial temporal lobe epilepsy -- Focal cortical dysplasia -- Epilepsy surgery -- Genetics of epilepsy; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2015.07.014
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: We report a unique case of refractory mesial temporal lobe epilepsy in siblings due to FCD type IIIa. Familial occurrence of epilepsy/febrile seizures points towards a possible genetic nature of the FCD type IIIa observed in presented cases. Abstract: Purpose: Focal cortical dysplasia (FCD) represents a common cause of refractory epilepsy. It is considered a sporadic disorder, but its occasional familial occurrence suggests the involvement of genetic mechanisms. Methods: Siblings with intractable epilepsy were referred for epilepsy surgery evaluation. Both patients were examined using video-EEG monitoring, MRI examination and PET imaging. They underwent left anteromedial temporal lobe resection. Results: Electroclinical features pointed to left temporal lobe epilepsy and MRI examination revealed typical signs of left-sided hippocampal sclerosis and increased white matter signal intensity in the left temporal pole. PET examination confirmed interictal hypometabolism in the left temporal lobe. Histopathological examination of resected tissue demonstrated the presence FCD type IIIa, i.e. hippocampal sclerosis and focal cortical dysplasia in the left temporal pole. Conclusion: We present a unique case of refractory mesial temporal lobe epilepsy in siblings, characterized by an identical clinical profile and histopathology of FCD type IIIa, who were successfully treated by epilepsy surgery. The presence of such a high concordance between the clinical and morphological data, together with the occurrence of epilepsy and febrile seizures in three generations of the family pedigree points towards a possible genetic nature of the observed FCD type IIIa.