Abstract
Focal cortical dysplasia (FCD) is a common cause of drug-resistant epilepsy, but its lesions may be subtle and difficult to detect on conventional magnetic resonance imaging. We report the case of a 24-year-old woman with childhood-onset focal epilepsy and frequent daily seizures. Video electroencephalography localized the epileptogenic focus to the left temporal and central regions. Conventional epilepsy MRI performed on a 1.5-Tesla scanner failed to clearly identify the lesion, whereas a 3-Tesla MRI using the HARNESS protocol demonstrated cortical thickening and increased signal intensity around the left Sylvian fissure, consistent with focal cortical dysplasia. The imaging findings enabled accurate localization of the epileptogenic lesion and supported further therapeutic planning, including consideration of epilepsy surgery in the event of drug resistance. This case highlights the value of the HARNESS MRI protocol on 3-Tesla scanners in improving the detection of subtle focal cortical dysplasia and optimizing presurgical evaluation in patients with epilepsy.
