Introduction Focal cortical dysplasia (FCD) is a most common cause of intractable focal epilepsy in children. Surgery is considered as a radical option for such patients with the prerequisite of lesion detection. Magnetic resonance imaging (MRI) plays a significant role in detection of FCDs in epilepsy patients; however, the detection of FCDs even in epilepsy dedicated MRI sequence shows relatively low positive rate. Last year, Middlebrooks et al introduced the novel three-dimensional Edge-Enhancing Gradient Echo (3D-EDGE) MRI sequence and using this sequence successfully identified five cases of FCDs which indicates its potential role in those epilepsy patients who may have FCDs.

Case Presentation We present a 14-year-old, right-handed, male patient who has suffered from drug-resistant epilepsy over the past 3 years. It was unable to localize the lesion of the seizure, even using the series of epilepsy dedicated MRI sequences. Inspired by the previous report, the lesion of the seizure was successfully targeted by 3D-EDGE sequence. Combined with intraoperative navigation and precisely removed the lesion. He was uneventfully recovered with no signs of cerebral dysfunction and no seizure recurrence 8 months after surgery.

Conclusion The 3D-EDGE sequences show a higher sensitivity for FCD detection in epilepsy patients compared with a series of epilepsy-dedicated MRI protocols. We confirmed that the study by Middlebrooks et al is of great clinical value. If the findings on routine MRI sequences or even epilepsy-dedicated MRI sequences were reported as negative, however, the semiology, video-electroencephalography, and fluorodeoxyglucose–positron emission tomography results suggest a local abnormality, and the results are concordant with each other, a 3D-EDGE sequence may be a good option.

简介 局灶性皮质发育不良 (FCD) 是儿童难治性局灶性癫痫的最常见原因。对于以病变检测为先决条件的此类患者，手术被认为是一种根治性选择。磁共振成像 (MRI) 在检测癫痫患者的 FCD 方面起着重要作用；然而，即使在癫痫专用 MRI 序列中 FCD 的检测也显示出相对较低的阳性率。去年，Middlebrooks 等人介绍了新型三维边缘增强梯度回波 (3D-EDGE) MRI 序列，并使用该序列成功识别了 5 例 FCD，这表明它在可能患有 FCD 的癫痫患者中具有潜在作用。

案例介绍 我们介绍了一名 14 岁的右撇子男性患者，他在过去 3 年中患有耐药性癫痫。它无法定位癫痫发作的病变，即使使用一系列癫痫专用 MRI 序列也是如此。受之前报道的启发，癫痫发作的病灶被3D-EDGE序列成功定位。结合术中导航，精准切除病灶。他顺利康复，没有脑功能障碍的迹象，手术后 8 个月也没有癫痫发作复发。

结论 与一系列癫痫专用 MRI 方案相比，3D-EDGE 序列对癫痫患者的 FCD 检测显示出更高的灵敏度。我们证实Middlebrooks等人的研究具有很大的临床价值。如果常规 MRI 序列甚至癫痫专用 MRI 序列的结果被报告为阴性，但是，症状学、视频脑电图和氟脱氧葡萄糖-正电子发射断层扫描结果表明局部异常，并且结果彼此一致，a 3D-EDGE 序列可能是一个不错的选择。