Abstract

Taylor's focal cortical dysplasia, first described by Taylor, is a cortical development anomaly and a prevalent cause of drug-resistant epilepsy in adults. Surgical intervention often yields a favorable prognosis if the lesion is entirely resected. Clinically, it presents with drug-resistant partial epilepsy from childhood, sometimes with an acquired, localizing neurological deficit. EEG typically shows continuous rhythmic spikes at the anomaly site. MRI scans fail to detect the lesion in about one-third of cases, making the identification of small dysplasias challenging. An appropriate MRI protocol and prior clinical and electrical localization are essential. The transmantle sign, marked by FLAIR and T2 hypersignal and T1 hyposignal in subcortical white matter extending to the ventricle, is highly characteristic and seen in 80% of cases. Isolated cortical thickening, showing dedifferentiation between white and gray matter, varies in size and is often located in the frontal lobe. Differentiating this from conditions like Bourneville's tuberous sclerosis and closed-lip schizencephaly is crucial.