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Brain 2004 127(11):2383-2384; doi:10.1093/brain/awh312
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Brain Vol. 127 No. 11 © Guarantors of Brain 2004; all rights reserved

Scientific Commentary

Surgery for focal cortical dysplasia

S. M. Sisodiya

Department of Clinical and Experimental Epilepsy, Institute of Neurology, UCL, Queen Square, London WC1N 3BG, UK, E-mail: sisodiya@ion.ucl.ac.uk

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Three decades since its comprehensive and elegant description (Taylor et al., 1971Go), focal cortical dysplasia (FCD) remains an enigmatic condition. Its true incidence is not well known, as even high-resolution MRI studies may not enable its detection. In surgical series, which are inevitably pre-selected, FCD is the most common developmental pathology identified. Undoubtedly, FCD may cause severe refractory epilepsy including epilepsia partialis continua or generalized status epilepticus that can be directly life-threatening. Despite the attention focused on FCD because of this not infrequent malign presentation, much of its biology remains obscure, from its molecular pathology to its natural history. For example, we do not know why paediatric and adult presentations may differ; we do not know if the newly comprehended cellular dynamics of the postnatal human brain, including neoneurogenesis, constitute an important component . . . [Full Text of this Article]


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