Deep characterization of refractory epilepsy due to mild malformation of cortical development with oligodendroglial hyperplasia (MOGHE) and insights into the role of invasive monitoring
Khoury J, Blümcke I, Busch RM, Krishnan B, Bulacio J, Bingaman W, Serletis D, Najm I (2026)
Publication Type: Journal article
Publication year: 2026
Journal
DOI: 10.1002/epi.70118
Abstract
Objective: Epilepsy surgery is an effective treatment option for patients with medically refractory epilepsy due to mild malformation of cortical development with oligodendroglial hyperplasia (MOGHE). The success of surgery depends on the accurate localization of the epileptogenic zone, which can be challenging due to the subtle imaging features. The aim of this project was to provide an in-depth electro-clinical characterization of MOGHE in patients with medically intractable epilepsy, and to assess the role of stereo-electroencephalography (SEEG) in tailoring the resection and optimizing surgical outcome. Methods: This single-center retrospective study analyzes a cohort of patients with medically intractable focal epilepsy who underwent surgery and had confirmed MOGHE on pathology evaluation. Clinical data, including demographics, electroclinical features (scalp EEG and invasive monitoring when available), surgical interventions, and postoperative outcomes were extracted from electronic medical records. Results: Of 23 patients identified, 10 (43%) underwent SEEG as part of their standard care. Seizure outcome data were available for 22 patients in this series. Median post-operative follow-up duration was 3.8 years. Fourteen patients (64%) were seizure-free (Engel 1). Seizure freedom in the SEEG group was 80% (n = 8/10), in comparison to the non-SEEG group (50%, n = 6/12). Success rate was related to complete resection of the regions sampled by SEEG electrodes involved in ictal onset, and a more extensive resection of the lesion (or near total lobectomy). Significance: Our results underscore the pivotal role of SEEG in enhancing surgical outcomes in patients with drug-resistant epilepsy due to MOGHE. SEEG proved particularly beneficial in defining resection margins, especially in cases where non-invasive data were discordant, scalp EEG patterns were generalized or poorly localized, and imaging findings were nonspecific, diffuse, or normal, making lesion identification challenging.
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APA:
Khoury, J., Blümcke, I., Busch, R.M., Krishnan, B., Bulacio, J., Bingaman, W.,... Najm, I. (2026). Deep characterization of refractory epilepsy due to mild malformation of cortical development with oligodendroglial hyperplasia (MOGHE) and insights into the role of invasive monitoring. Epilepsia. https://doi.org/10.1002/epi.70118
MLA:
Khoury, Jean, et al. "Deep characterization of refractory epilepsy due to mild malformation of cortical development with oligodendroglial hyperplasia (MOGHE) and insights into the role of invasive monitoring." Epilepsia (2026).
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