A case of focal epilepsy associated with focal cortical dysplasia and crossed cerebellar diaschisis

摘要

We here reported a 24-year-old woman who presented complex partial seizure from 15 years of age. Her brain MRI showed the right perirolandic focal cortical dysplasia (FCD) corresponding to the orofacial division of the primary sensori-motor area. On SPECT (Tc-99 mECD) study, hypoperfusion was demonstrated at the FCD, the right pons and the left cerebellum (crossed cerebellar diaschisis (CCD)). Magnetoencephalography disclosed the current source of the focal spikes was localized on the FCD. To our knowledge, no previous report of a case associated with FCD and CCD was found. We speculated the pathomechanism of the CCD might be related to the persistent epileptogenic firing which inhibited the cerebellar metabolism transsynaptically through cortico (FCD)-ponto-cerebellar pathway.