Focal Cortical Gliosis and ULEGYRIA Causing Focal Epilepsy

Focal epilepsy affects only one side of body and in most cases, consciousness is preserved during seizures. However, in some cases, seizures can spread to the opposite side (known as secondary generalisation), which can lead to loss of consciousness. In several cases of focal epilepsy, structural changes on MRI can be seen.

This case is of an adolescent, who presented with recurrent right focal motor seizures with secondary generalisation. MRI brain (figures above) showed features of focal atrophy and ulegyria affecting left parietal lobe. Ulegyria is identified by its characteristic “mushroom-shaped” gyri, in which scarring causes shrinkage and atrophy in the deep sulcal regions while the surface gyri are spared. The gliosis and atrophy are usually caused by hypoxia or ischemia during perinatal period.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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