Type II focal cortical dysplasia: electroclinical study and surgical outcome in 31 pediatric patients

Abstract

Our results confirm that surgery is the best treatment option for pediatric patients with refractory focal epilepsy due to type II FCD. A statistically significant correlation was found between a good prognosis and age at epilepsy onset older than 2 years.

Outcome after epilepsy surgery for cortical dysplasia in children

“…Several FCD series in children have been published in the post MRI era [7,8,[15][16][17][18][19][20][21][22][23]. The overall seizure-freedom rates range from 40 to 73 %, at about 2 years after surgery; most studies report 50-55 % success rate.…”

Editorial. Utility of intraoperative ultrasound for the resection of focal cortical dysplasia

“…FCD tends to produce early-onset epilepsy that is typically drug resistant and prone to bouts of status epilepticus, and yet it may respond to surgical intervention. 4,5,11 In fact, in the case of FCD type II, surgery may yield the best results. 11 The primary predictor of surgical outcome in FCD is the extent of resection.…”

“…4,5,11 In fact, in the case of FCD type II, surgery may yield the best results. 11 The primary predictor of surgical outcome in FCD is the extent of resection. 5,11 Unfortunately, the offending lesions in FCD are generally difficult to visualize intraoperatively.…”

“…11 The primary predictor of surgical outcome in FCD is the extent of resection. 5,11 Unfortunately, the offending lesions in FCD are generally difficult to visualize intraoperatively. The authors Noli et al directly attributed surgical failure to the "difficulties defining the epileptogenic zone in the majority of the patients, and the anatomical location in one."…”

“…The authors Noli et al directly attributed surgical failure to the "difficulties defining the epileptogenic zone in the majority of the patients, and the anatomical location in one." 11 The indistinct boundaries between dysplastic tissue and normal brain as well as the difficulty operating around eloquent cortex probably explains the historically poor outcomes after surgery. Unlike tumor resection, FCD also doesn't lend itself to tactile discrimination because the dysplastic lesion consists of otherwise normal cortical tissue.…”