Epilepsy surgery in children with focal cortical dysplasia (FCD): results of long-term seizure outcome.

摘要: The purpose of this study was to assess the effect epilepsy surgery on seizure outcome in children and adolescents under 18 years with intractable due focal cortical dysplasia. We analysed clinical data, such as age at onset, course, localisation focus from presurgical evaluation, MRI, tissue pathology 68 patients 6 months 9 after surgery. Seizure classified according Engel classification. Mean onset 7 months, ranging first days life years. All had medically epilepsy. Localisation lesion predominantly extratemporal: posterior (uni- or multilobar) 43 %, frontal without central region 26 multilobar involving area 19 % temporal 12 %. MRI signs typically seen dysplasia (FCD) localised blurring gray-white matter junction found dysgyria 62 thickening ribbon 46 T2 signal elongation subcortical white 40 patients' MRI. Age ranged 5 16 years; 14 were 2 when operated on. In 34 (6 3 years) subdural grid electrode evaluation performed prior Pathology revealed balloon cells (type I) 60 FCD cell subtype II) specimens. Postoperative complications hygroma an increased motor deficit patients. Up two 50 free (Engel class I), 10 II, 33 III unchanged IV). Long-term (> post surgery) 32 showed similar results (class I II 28 IV %). Complete resection dysplastic significantly correlated favorable outcome, whereas not different mild FCD. Children no better than infancy preschool age. Epilepsy resulted good control