Reader Response: One-Stage, Limited-Resection Epilepsy Surgery for Bottom-of-Sulcus Dysplasia

Dr. Macdonald-Laurs et al. reported 38 patients with bottom-of-sulcus dysplasia (BOSD), who underwent a limited corticectomy and whose seizure outcomes indicated minor neurologic complications,1 echoing previous literature.2,3 Although subtle changes can be found from structural MRIs, combined fluorodeoxyglucose (FDG)-positron emission tomography (FDG-PET) and MRI imaging can produce high sensitivity in detecting these small lesions. Because these lesions are well confined, sulcus-centered resections could be considered for better function protection, while also guaranteeing the seizure outcome.4