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Title: Intraoperative definition of bottom-of-sulcus dysplasia using intraoperative ultrasound and single depth electrode recording - A technical note
Austin Authors: Miller, Dorothea;Carney, Patrick W ;Archer, John S ;Fitt, Gregory J ;Jackson, Graeme D ;Bulluss, Kristian J 
Affiliation: Department of Neurosurgery, Austin Health, Heidelberg, Victoria, Australia
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Box Hill, Victoria, Australia
University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia
Department of Neurosurgery, Essen University Hospital, Essen, Nordrhein-Westfalen, Germany
Issue Date: Feb-2018
Date: 2017-11-11
Publication information: Journal of Clinical Neuroscience 2017; 48: 191-195
Abstract: Bottom of sulcus dysplasias (BOSDs) are localized focal cortical dysplasias (FCDs) centred on the bottom of a sulcus that can be highly epileptogenic, but difficult to delineate intraoperatively. We report on a patient with refractory epilepsy due to a BOSD, successfully resected with the aid of a multimodal surgical approach using neuronavigation based on MRI and PET, intraoperative ultrasound (iUS) and electrocorticography (ECoG) using depth electrodes. The lesion could be visualized on iUS showing an increase in echogenicity at the grey-white matter junction. IUS demonstrated the position of the depth electrode in relation to the lesion. Depth electrode recording showed almost continuous spiking. Thus, intraoperative imaging and electrophysiology helped confirm the exact location of the lesion. Post-resection ultrasound demonstrated the extent of the resection and depth electrode recording did not show any epileptiform activity. Thus, both techniques helped assess completeness of resection. The patient has been seizure free since surgery. Using a multimodal approach including iUS and ECoG is a helpful adjunct in surgery for BOSD and may improve seizure outcome.
DOI: 10.1016/j.jocn.2017.10.045
Journal: Journal of Clinical Neuroscience
PubMed URL:
Type: Journal Article
Subjects: Bottom-of-sulcus dysplasia
Depth electrodes
Focal cortical dysplasia
Intraoperative ultrasound
Appears in Collections:Journal articles

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