Surgical treatment of epilepsy in children caused by focal cortical dysplasia

Roger J. Hudgins*, J. Robert Flamini, Susan Palasis, Raymond Cheng, Thomas G. Burns, C. Lynn Gilreath

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Focal cortical dysplasia (FCD) is a congenital disorder of neuronal migration that is increasingly recognized as a common cause of seizures in children, occurring in 20-30% of all surgically treated cases of epilepsy in the pediatric population. Advances in neuroimaging have contributed to recognition of FCD. We report 15 children (9 female, 6 male) with FCD and surgically treated intractable epilepsy. In 9 cases, a surgical strategy of anatomic (frameless stereotactic) grid placement and physiologic (electrocorticography) resection was employed. Postoperative MRI scans were obtained, the pathologic specimen was graded according to the Brannstrom system, and seizure outcome was defined using the Engel classification. There were no deaths and no permanent morbidity. After, on average, 4 years since treatment, 10 children are seizure free, 2 are 2A, 2 are 2B and 1 is 3A. Predictors of good outcome are an MRI-defined lesion and increased cortical disorganization (higher Brannstrom grade). Subtotal resection did not preclude a seizure-free outcome.

Original languageEnglish (US)
Pages (from-to)70-76
Number of pages7
JournalPediatric neurosurgery
Volume41
Issue number2
DOIs
StatePublished - Mar 1 2005

Keywords

  • Epilepsy
  • Focal cortical dysplasia
  • Frameless stereotaxy
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Clinical Neurology

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