Commentary on the new ILAE classification system for focal cortical dysplasias.

摘要

I promptly applied the new International League Against Epilepsy (ILAE) classification system for focal cortical dysplasias (FCDs) (Bliimcke et al., 2011) and noted its effective properties. However, in my opinion three aspects of this classification are challenging.1 Hypertrophic pyramidal neurons outside layer 5: In the Palmini system (Palmini et al., 2004), the presence of "giant neurons" identified FCD type IB. However, these neurons have been ambiguously defined ("do not overexpress cytoplasmic neurofilaments" Palmini et al.,2004; "accumulate neurofilament proteins within the cytoplasm" Blumcke et al., 2006), so as to be not easily identifiable. Indeed, Chamberlain et al. (2009) demonstrated that the diagnosis for which there was the least agreement was FCD type IB. Nevertheless, in the new classification system these UFO (unidentifiable faint object) neurons continue to be considered in the setting of FCD type I.