Title: Surgery for intractable epilepsy due to focal cortical dysplasia
Abstract: Objective Focal cortical dysplasia (FCD) frequently is associated with medically intractable epilepsy.The purpose of this paper was to identify the subtypes of FCD that would be useful for differential diagnosis,to introduce the protocol of surgery for FCD at“Claudio Munari”Surgery Center for Epilepsy,Niguarda Ca' Granda hospital in Milan,Italy.Methods We reviewed 81 intractable epilepsy patients who were diagnosed FCD according to the pathological criteria from June 1996 to December 2003, among these cases architectural dysplasia (AD,42),cytoarchitectural dysplaisa (CD,12),Taylor's focal cortical dysplaisa (TFCD,27).All patients underwent MRI (Positive 65%),scalp EEG and video EEG before surgery,and 61% patients also received stereo-EEG.Results The average outcome of FCD surgery was 54% (Engle Ia) after at least one year of follow up.The best outcome was observed in TFCD group:69% seizure free,compared with 45% of CD and 49% of AD group.In patients with AD,the epileptogenic zone was mainly in the temporal lobe and there was a lower seizure frequency than in patients with CD and TFCD.In patients with TFCD,the epileptogenic zone was mainly in extra-temporal,and a distinctive interictal stereo-EEG had been identified.Conclusions According to this simplified classification of FCD based on easily recognized neuropathological characteristics,integrating with SEEG in some cases,we could further study the correlations between each category with its clinical,VEEG features and surgical outcome.
Publication Year: 2006
Publication Date: 2006-01-01
Language: en
Type: article
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