Clinicopathological features and surgical outcomes of intractable epilepsy due to focal cortical dysplasia

Abstract

Objective To study the correlation with subtypes of focal cortical dysplasia(FCD) and surgical outcomes in patients with intractable epilepsy due to FCD.Method According to Palmini's FCD classification,the clinical,radioiogical and pathological features of 42 intractable epilepsy patients of FCD received surgical treatment were reviewed retrospectively.Results Among 42 epilepsy patients,the FCD lesions were located in 24 temporal lobes,14 frontal lobes,6 parietal lobes,3 occipital lobes,5 multilple lesions.The positive rate of preoperative MRI examination was 62%.The subtypes of FCD were identified as following:FCD type Ⅰ A in 9,FCD type Ⅰ B in 21,FCD type Ⅱ A in 5 and FCD type Ⅱ B in 7,respectively.FCD type Ⅰ B was the predominant pathological subtype and almost located in temporal lobe associated hippocampal sclerosis.The curative rate of FCD surgery in temporal lobe epilepsy group was 67% and that in extratemporal group was 43% (Engle Ⅰ a)during follow -up period (at leastⅠ year).Conclusions FCD is a common cause of intractable epilepsy.The different intrinsic neuropathological characteristics,particularly the potential epileptogenic feature,have significant correlations with clinical findings.Further study should be made between each category with its surgical outcome. Key words: Focal cortical dysplasia; Intractable epilepsy; Pathology; Surgical procedures,operative