Document Detail


Electroclinical and imaging findings in ulegyria and epilepsy: a study on 25 patients.
MedLine Citation:
PMID:  17682014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Ulegyria refers to cerebral cortex scarring, which results from a perinatal ischaemic brain injury. It presents with a characteristic gyral pattern: small circumvolutions with atrophy at sulci bottom and spared apex. Ulegyria is frequently associated with epilepsy, cerebral palsy and mental disability. We analysed electroclinical and MRI features in patients with ulegyria and epilepsy. PATIENTS AND METHODS: We reviewed 25 patients (14 males/11 females) with ulegyria and epilepsy from the database (about 5000 patients with epilepsy) of our unit. Patients were examined clinically, underwent high resolution MRI, EEG recordings, positron emission tomography, single photon emission computed tomography and neuropsychological testing. Two patients with refractory seizures underwent epilepsy surgery. RESULTS: Mean age of patients was 34 years (5-66) at the reassessment time. The majority (16/25, 64%) had a history of perinatal asphyxia. 15 patients had delayed developmental milestones; 20 had learning disabilities and five patients were severely disabled. Mean age at seizure onset was 4.2 years (1-18). 17 patients (68%) had medically intractable epilepsy. 11 patients (44%) had occipital lobe seizures. The majority (n = 24, 96%) had parieto-occipital lesions on MRI. In 13 patients (52%), ulegyria was bilateral. 12 patients (48%) had hippocampal sclerosis. Two patients underwent epilepsy surgery with an excellent postoperative outcome (Engel class IA and IC). CONCLUSION: Patients with ulegyria often have a history of perinatal asphyxia and present with pharmacoresistant seizures. Their presurgical assessment is complicated because of frequent dual pathology (hippocampal sclerosis) and bilateral lesions.
Authors:
G Kuchukhidze; I Unterberger; J Dobesberger; N Embacher; G Walser; E Haberlandt; T Gotwald; H Maier; M Ortler; S Felber; G Bauer; E Trinka
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Publication Detail:
Type:  Journal Article     Date:  2007-08-06
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  79     ISSN:  1468-330X     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-14     Completed Date:  2008-04-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  547-52     Citation Subset:  IM    
Affiliation:
Department of Neurology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Asphyxia Neonatorum / complications*,  pathology
Atrophy
Brain Damage, Chronic / diagnosis*,  pathology
Brain Ischemia / complications*,  pathology
Cerebral Cortex / pathology*
Child
Child, Preschool
Cicatrix / diagnosis*
Echo-Planar Imaging*
Electroencephalography*
Epilepsies, Partial / diagnosis*,  pathology
Female
Fetal Hypoxia / complications*,  pathology
Follow-Up Studies
Humans
Infant
Infant, Newborn
Magnetic Resonance Imaging*
Male
Middle Aged
Neurologic Examination*
Neurons / pathology

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