Focal cortical dysplasia, Taylor type

Findings

The MRI of the brain shows T2 and FLAIR hyper intense arrow-shaped left frontal white matter lesion pointing toward the frontal horn of the left lateral ventricle. There is no abnormal enhancement. There is mild hypo intensity on T1 sequences.

Differential diagnosis:
- Focal cortical dysplasia
- Gliosis
- Glial cell tumor
- Physiologic margination of white matter neurons


Diagnosis: Focal cortical dysplasia, Taylor type


Key points

Focal cortical dysplasia is considered to be in the spectrum of migrational disorders of the brain, and often manifests in the form of seizures, developmental delay and focal neurologic deficits. Focal cortical dysplasia is thought to represent the cause of between 5% and 25% of patients with focal epilepsy. This entity typically manifests in the first years of life. Antiepileptic medications are the first line of therapy, and no particular medications have been found to be more or less effective for focal cortical dysplasia. After two failed rounds of antiepileptic regimens, surgical interventions may be considered.


Radiology

MRI is the examination of choice for identifying focal cortical dysplasia. The typical appearance of the Taylor type of this disorder is that of T2/FLAIR hyper intensity within the sub cortical white matter, tapering toward the lateral ventricle. The most typical location of this finding is unilaterally within the frontal lobes. The lesions do not enhance.