Familial temporal lobe epilepsy due to focal cortical dysplasia type IIIa


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.

DOI: 10.1016/j.seizure.2015.07.014

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@article{Fabera2015FamilialTL, title={Familial temporal lobe epilepsy due to focal cortical dysplasia type IIIa}, author={Petr Fabera and Hana Krijtov{\'a} and Martin Tom{\'a}{\vs}ek and David Kr{\'y}sl and Josef Z{\'a}me{\vc}n{\'i}k and Milan Mohapl and Premysl Jiruska and Petr Marusic}, journal={Seizure}, year={2015}, volume={31}, pages={120-123} }