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. 2007 Aug;78(8):853-6.
doi: 10.1136/jnnp.2006.105361. Epub 2007 Feb 7.

Focal cortical dysplasia: long term seizure outcome after surgical treatment

T Kral  1 , M von Lehe, M Podlogar, H Clusmann, P Süssmann, M Kurthen, A Becker, H Urbach, J Schramm
Affiliations

Focal cortical dysplasia: long term seizure outcome after surgical treatment

T Kral et al. J Neurol Neurosurg Psychiatry. 2007 Aug.

Abstract

Background: Studies of long term outcome after epilepsy surgery for cortical malformations are rare. In this study, we report our experience with surgical treatment and year to year long term outcome for a subgroup of patients with focal cortical dysplasia (FCD).

Methods: We retrospectively analysed the records of 49 patients (females n = 26; males n = 23; mean age 25 (11) years) with a mean duration of epilepsy of 18 years (range 1-45). Preoperative MRI, histological results based on the Palmini classification and clinical year to year follow-up according to the International League Against Epilepsy (ILAE) classification were available in all patients.

Results: 98% of patients had a lesion on preoperative MRI. In addition to lobectomy (n = 9) or lesionectomy (n = 40), 14 patients had multiple subpial transections of the eloquent cortex. The resected tissue was classified as FCD type II b in 41 cases with an extratemporal (88%) and FCD type II a in 8 cases with a temporal localisation (100%). After a mean follow-up of 8.1 (4.5) years, 37 patients (76%) were seizure free, a subgroup of 23 patients (47%) had been completely seizure free since surgery (ILAE class 1a) and 4 patients (8%) had only auras (ILAE class 2). Over a 10 year follow-up, the proportion of satisfactory outcomes decreased, mainly within the first 3 years. During long term follow-up, 48% stopped antiepileptic drug treatment, 34% received a driver's license and 57% found a job or training.

Conclusion: Surgical treatment of epilepsy with FCD is not only successful in the short term but also has a satisfying long term outcome which remains constant after 3 years of follow-up but is not associated with better employment status or improvement in daily living.

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Conflict of interest statement

Competing interests: None.

References

    1. Colombo N, Tassi L, Galli C.et al Focal cortical dysplasias: MR imaging, histopathologic, and clinical correlations in surgically treated patients with epilepsy. AJNR Am J Neuroradiol 200324724–733. - PMC - PubMed
    1. Urbach H, Scheffler B, Heinrichsmeier T.et al Focal cortical dysplasia of Taylor's balloon cell type: a clinicopathological entity with characteristic neuroimaging and histopathological features, and favorable postsurgical outcome. Epilepsia 20024333–40. - PubMed
    1. Chung C K, Lee S K, Kim K J. Surgical outcome of epilepsy caused by cortical dysplasia. Epilepsia 200546(Suppl 1)25–29. - PubMed
    1. Hader W J, Mackay M, Otsubo H.et al Cortical dysplastic lesions in children with intractable epilepsy: role of complete resection. J Neurosurg 2004100(2 Suppl Pediatrics)110–117. - PubMed
    1. Hong S C, Kang K S, Seo D W.et al Surgical treatment of intractable epilepsy accompanying cortical dysplasia. J Neurosurg 200093766–773. - PubMed