Focal cortical dysplasia: long term seizure outcome after surgical treatment

Abstract

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.

FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

“…11,[20][21][22] Studies report that 30% to 70% of patients with type I CD have positive structural MRI scans, compared with 80% to 100% of those with type II CD. 9,10,12,16,23,24 Put another way, 20% to 60% of epilepsy surgery patients with normal MRI scans are reported to have type I CD at histopathology. 13,14,25,26 Thus, structural MRI underreports CD in patients with refractory epilepsy, especially in those with type I CD.…”

“…This is especially true for patients with type II CD in whom structural MRI and functional neuroimaging often identify the lesion. [7][8][9][10] However, patients with type I CD are a challenge in that they often have negative MRI scans, making surgical treatment difficult without knowing the exact location and borders necessary for complete lesion removal. [11][12][13][14][15][16] Supplemental data at www.neurology.…”

[18F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy

“…Many type I FCD MR images are read as having normal findings. [22][23][24][25] In comparison, FDG-PET can identify FCD despite normal MR imaging findings. 7,26 One study found that MR imaging detected 83% of severe FCD, whereas FDG-PET detected 90%.…”

Correlation of the patterns of behavior in focal epileptic seizures and localization of the epileptic lesions

“…Kao i u većini prehirurških serija (148,149), i u našoj grupi, pokazana je dominantna lokalizacije lezije u mezijalnom temporalnom režnju i ukupna dominacija epileptogene lezije u temporalnom i frontalnom korteksu (82%). Za razliku od drugih serija (84) u našoj grupi dominantna je učestalost temporalnih epilepsija (73%) što apsolutno govori o sklonosti regrutera Klinike za neurologiju KCS da bolesnike u video-EEG monitoring primaju prvenstveno prema indikaciji prehirurške evaluacije, jer se, aktuelno, hirurški program bazira na neinvazivnom monitoringu (gde dominiraju lezioni slučajevi i temporalne lobektomije).…”

“…Hirurška resekcija može biti od velike koristi za neke bolesnika sa fokalnom epilepsijom, kod kojih antiepileptična terapija ne ostvaruje svoj puni benefit (158,84,149). Uprkos velikim tehnološkim prodorima u video-EEG monitoringu, tehnikama neuroimidžinga i metoda invazivnog mapiranja sa dubokim i/ili subduralnim elektrodama, hirurgija epilepsije je uspešna u ostvarivanju pune kontrole napada duže od 10 godine posle operacije samo kod jedne polovine (49%) (105).…”