Jorge Luis Ramírez-Molina1, Roberta Di Giacomo2, Valeria Mariani3, Francesco Deleo4, Francesco Cardinale5, Angélica María Uscátegui-Daccarett6, Pablo Lorenzana7, Laura Tassi8. 1. Neurology Unit, Department of Internal Medicine, Universidad Nacional de Colombia, Carrera 30 No. 45-03, Bogotá, Colombia. Electronic address: jolramirezmo@unal.edu.co. 2. Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio", Neurological Clinic 'SS. Annunziata' via dei Vestini, 66100 Chieti, Italy. Electronic address: roberta.digiacomo84@gmail.com. 3. "C. Mondino" National Neurological Institute, Pavia, Italy; "Claudio Munari" Epilepsy Surgery Centre, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. Electronic address: valeriamariani85@gmail.com. 4. Clinical and Experimental Epileptology Unit, Istituto Neurologico "Carlo Besta", Via G. Celoria, 11, 20133 Milano, Italy; Department of Neurology, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada. Electronic address: francesco.deleo@istituto-besta.it. 5. "Claudio Munari" Epilepsy Surgery Centre, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. Electronic address: francesco.cardinale@ospedaleniguarda.it. 6. Neuropediatrics Unit, Department of Pediatrics, Universidad Nacional de Colombia, Carrera 30 No. 45-03, Bogotá, Colombia. Electronic address: amuscateguid@unal.edu.co. 7. Neurology Unit, Department of Internal Medicine, Universidad Nacional de Colombia, Carrera 30 No. 45-03, Bogotá, Colombia. Electronic address: plorenzanap@unal.edu.co. 8. "Claudio Munari" Epilepsy Surgery Centre, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. Electronic address: laura.tassi@ospedaleniguarda.it.
Abstract
OBJECTIVE: Focal Cortical Dysplasias (FCDs) represent a common architectural cortical disorder underlying drug-resistant focal epilepsy. So far, studies aimed at evaluating whether age at surgery is a factor influencing surgical outcome are lacking, so that data on the comparison between patients harboring Type II FCD operated at younger age and those operated at adult age are still scarce. We compared presurgical clinical features and surgical outcomes of patients with histopathologically diagnosed Type II FCD undergoing surgery at an earlier age with those operated after 20 years of age. METHODS: We retrospectively analyzed 1660 consecutive patients operated at the "Claudio Munari" Epilepsy Surgery Centre. There were 289 patients (17.4%) with a neuropathological diagnosis of Type II FCD. We included two different groups of patients, the first one including patients operated on at less than 6years, the second sharing the same seizure onset age but with delayed surgery, carried out after the age of 20. Seizure characteristics and, neuropsychological and postoperative seizure outcomes were evaluated by study group. RESULTS: Forty patients underwent surgery before the age of 6 and 66 patients after the age of 20. Surgical outcome was favorable in the whole population (72.6% were classified in Engel's Class Ia+Ic), independently from age at surgery. In the children group, 32 patients were classified in Class I, including 30 (75%) children in classes Ia and Ic. In the adult group, 53 belonged to Class I of whom 47 (71%) were in classes Ia and Ic. The percentage of permanent complications, the surgical outcomes, and AED withdrawal did not significantly differ by study group. CONCLUSION: Our results indicate that there is no difference between the groups, suggesting that outcome depends mainly on the histological findings and not on timing of surgery.
OBJECTIVE: Focal Cortical Dysplasias (FCDs) represent a common architectural cortical disorder underlying drug-resistant focal epilepsy. So far, studies aimed at evaluating whether age at surgery is a factor influencing surgical outcome are lacking, so that data on the comparison between patients harboring Type II FCD operated at younger age and those operated at adult age are still scarce. We compared presurgical clinical features and surgical outcomes of patients with histopathologically diagnosed Type II FCD undergoing surgery at an earlier age with those operated after 20 years of age. METHODS: We retrospectively analyzed 1660 consecutive patients operated at the "Claudio Munari" Epilepsy Surgery Centre. There were 289 patients (17.4%) with a neuropathological diagnosis of Type II FCD. We included two different groups of patients, the first one including patients operated on at less than 6years, the second sharing the same seizure onset age but with delayed surgery, carried out after the age of 20. Seizure characteristics and, neuropsychological and postoperative seizure outcomes were evaluated by study group. RESULTS: Forty patients underwent surgery before the age of 6 and 66 patients after the age of 20. Surgical outcome was favorable in the whole population (72.6% were classified in Engel's Class Ia+Ic), independently from age at surgery. In the children group, 32 patients were classified in Class I, including 30 (75%) children in classes Ia and Ic. In the adult group, 53 belonged to Class I of whom 47 (71%) were in classes Ia and Ic. The percentage of permanent complications, the surgical outcomes, and AED withdrawal did not significantly differ by study group. CONCLUSION: Our results indicate that there is no difference between the groups, suggesting that outcome depends mainly on the histological findings and not on timing of surgery.
Authors: Renzo Guerrini; Mara Cavallin; Tommaso Pippucci; Anna Rosati; Francesca Bisulli; Paola Dimartino; Carmen Barba; Rita Garbelli; Anna Maria Buccoliero; Laura Tassi; Valerio Conti Journal: Neurol Genet Date: 2020-12-08
Authors: Attila Rácz; Albert J Becker; Carlos M Quesada; Valeri Borger; Hartmut Vatter; Rainer Surges; Christian E Elger Journal: Front Neurol Date: 2021-06-09 Impact factor: 4.003
Authors: Nisha Gadgil; Melissa A LoPresti; Matthew Muir; Jeffrey M Treiber; Marc Prablek; Patrick J Karas; Sandi K Lam Journal: Surg Neurol Int Date: 2019-12-27