Non-dominant, Lesional Frontal Lobe Epilepsy Overlapping with Motor Cortex

This chapter discusses a patient with dominant, pharmacoresistant epilepsy due to focal cortical dysplasia undergoing intracranial monitoring to delineate resection margins. We briefly discuss the normal variants with epileptiform semblance on intracranial monitoring and the importance of their distinction from epileptiform patterns during surgical decision-making process. We describe some of the ictal onset patterns during intracranial monitoring in patients with focal cortical dysplasia. We also shed light on the aberrant sensorimotor circuit organization within dysplastic cortex while maintaining normal sensorimotor function. We discuss in depth the possible surgical interventions in patients with focal cortical dysplasia, post-operative outcomes and the predictors of seizure freedom. Lastly, we analyze symptomatogenesis of ictal paresthesia and other viscerosensory manifestations.