Epilepsy surgery in patients with malformations of cortical development

Hans Lüders*, Stephan U. Schuele

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

54 Scopus citations


Purpose of review: Patients with malformations of cortical development often suffer from intractable focal epilepsy. This review considers recent progress in the selection and seizure outcome of patients undergoing resective epilepsy surgery for this condition. Recent findings: Patients with malformations of cortical development restricted to part or even a whole hemisphere may be candidates for epilepsy surgery even when, due to microscopic malformations, magnetic resonance imaging shows no detectable lesion. Despite recent advances in structural and functional imaging, the majority of patients with this condition undergo invasive evaluation. Patients with focal cortical dysplasia, with and without a detectable lesion on magnetic resonance imaging, often have a favorable outcome with epilepsy surgery. The underlying pathological substrate seems to be a better predictor for surgical outcome in patients with focal cortical dysplasia than the presence of a lesion on magnetic resonance imaging. Epilepsy surgery can be offered in a highly selected subgroup of patients with unilateral nodular heterotopia. Seizures in hemimegalencephaly may respond favorably to hemispherectomy, although most children will continue to have seizures and significant functional impairments. Summary: Patients with focal epilepsy due to malformations of cortical development are often intractable to medical management. Resective epilepsy surgery can be beneficial, particularly for patients with focal cortical dysplasia and unilateral hemispheric malformations.

Original languageEnglish (US)
Pages (from-to)169-174
Number of pages6
JournalCurrent Opinion in Neurology
Issue number2
StatePublished - Apr 1 2006


  • Eloquent cortex
  • Epilepsy surgery
  • Focal cortical dysplasia
  • Malformation of cortical development
  • Neocortical epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


Dive into the research topics of 'Epilepsy surgery in patients with malformations of cortical development'. Together they form a unique fingerprint.

Cite this