We thank Dr. Hu et al. for their encouraging comments on our article.¹ Both our groups advocate minimal, targeted resections of bottom-of-sulcus dysplasia (BOSD),^1,2 and we further promote omitting intracranial EEG monitoring in MRI-positive cases. As noted in references 41–45 in our article, laser interstitial thermal therapy (LITT) and stereotactic thermocoagulation (STC) are reported in BOSD, further minimize surgical intervention, and are appropriate for BOSD on the medial and basal cerebral surfaces—occurrences which are not as easily accessed with a small craniotomy as BOSD on the cerebral convexity. STC is typically undertaken in patients who undergo previous stereo-EEG with an electrode directly sited in an MRI-positive BOSD. The potential disadvantages of LITT and STC are the lack of confirmation of epileptogenicity with electrocorticography, a pathologic diagnosis from histopathology, and identification of genetic variants from deep sequencing of tissue.

我们感谢胡博士等人。感谢他们对我们文章的鼓舞人心的评论。¹我们的两个小组都提倡对沟底发育不良 (BOSD) 进行最小化、有针对性的切除术，^1,2我们进一步提倡在 MRI 阳性病例中省略颅内 EEG 监测。正如我们文章中的参考文献 41-45 所指出的，激光间质热疗 (LITT) 和立体定向热凝疗法 (STC) 在 BOSD 中有所报道，进一步减少了手术干预，并且适用于内侧和基底脑表面的 BOSD——发生在不像 BOSD 在大脑凸面上那样容易通过小开颅手术进入。STC 通常在接受过立体 EEG 的患者中进行，电极直接位于 MRI 阳性 BOSD 中。LITT 和 STC 的潜在缺点是缺乏用皮质电图证实致痫性、组织病理学的病理诊断以及组织深度测序的遗传变异鉴定。