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Relatively little is known about language cortex representation in patients with developmental pathology and epilepsy. We report the results of mapping language by electrical stimulation of chronically implanted subdural electrodes in 34 patients (mean age, 12.2 years) evaluated for epilepsy surgery, 28 of whom had magnetic resonance imaging or histological(More)
Conventional cortical stimulation based on pulses of fixed duration briefer than the chronaxie rarely elicit responses in infants and young children. We developed a stimulation paradigm that relies on increments in both stimulus intensity and pulse duration. This approach ensures that stimulation parameters converge to the chronaxie by mathematically(More)
A 32-month-old child presented in status epilepticus (SE) involving the left side of the body. Fast spin-echo magnetic resonance imaging (FSE-MRI) with hippocampal volumetry performed < or = 24 h after the seizure showed increased T2 signal of the right hippocampus, but no atrophy. Complex partial seizures (CPS) appeared at age 33 months, and three more(More)
BACKGROUND Two pathologic subtypes based on the presence or absence of balloon cells have been described in cortical dysplasia of Taylor (CDT). OBJECTIVE To determine whether the pathologic subtype has any distinct clinical or MRI features that are relevant to management. METHODS The histopathologic, clinical, and MRI features of 34 children with CDT(More)
OBJECTIVE Focal cortical dysplasia (FCD) is the most frequent pathological finding in pediatric epilepsy surgery patients. Several histopathological types of FCD are distinguished. The aim of the study was to define distinctive features of FCD subtypes. METHODS We retrospectively reviewed clinical, electroencephalographic, magnetic resonance imaging,(More)
BACKGROUND Focal cortical dysplasia (FCD) is recognized as the major cause of focal intractable epilepsy in childhood. Various factors influencing postsurgical seizure outcome in pediatric patients with FCD have been reported. OBJECTIVE To analyze different variables in relation to seizure outcome in order to identify prognostic factors for selection of(More)
The spikes in benign rolandic epilepsy (BRE) typically involve both the central and midtemporal regions as recorded on standard EEG montages, but the seizures are characterized by sensorimotor manifestations that are rarely referrable to the temporal lobe. To study this apparent disparity, we evaluated the field distribution of interictal spikes in 33 BRE(More)
Differentiating seizures from pseudoseizures frequently is challenging in very young children manifesting repetitive, stereotypic behavior. Using video electroencephalographic recording, we evaluated 60 patients, younger than 10 years of age, with episodic signs and symptoms believed to be seizures despite repeatedly normal routine electroencephalograms.(More)
The pitfalls and difficulties in accurately localizing seizure foci are reviewed. Basic issues regarding modeling, volume conduction, inhomogeneities, and corticocortical propagation are discussed, and the limitations of scalp and intracranial recordings are outlined. The ambiguities in interpreting patterns and their significance are highlighted with a(More)
We investigated a 6-month-old infant with daily episodes of left hemifacial contraction, head and eye deviation to the right, nystagmoid jerks to the right, autonomic dysfunction, and retained consciousness. The episodes began on day 1 of life and were unresponsive to antiepileptic medication. Interictal and ictal scalp electroencephalographic (EEG)(More)