The clinical, EEG and neuroimaging features in 100 adult patients with cerebral cortical dysgenesis (CD) were reviewed at the National Hospital for Neurology and Neurosurgery, St Mary’s Hospital, London, and the National Society for Epilepsy, Chalfont St Peter, Gerrards Cross, UK. Patients had medically refractory epilepsy with onset at a median age of 10 years. Only 15% had a history of status epilepticus. Diagnosis was by neuroimaging in 70. EEGs were abnormal in 95%. Of 35 patients treated by surgery, 15 were completely seizure-free. Demonstration of subtle forms of CD by MRI lessen the incidence of cryptogenic epilepsy in adult patients. [1]

COMMENT. The heterogeneity of abnormalities associated with CD in adults with epilepsy, as listed in the title of this article, was associated with varied clinical, EEG and MRI features. Compared to children with epilepsy and CD, these adult patients had a relatively low frequency of delayed milestones (12%), mental retardation (11%) and neurologic deficits (17%).