Cihan Isler1, Baris Kucukyuruk1, Cigdem Ozkara2, Aysegul Gunduz2, Merih Is3, Taner Tanriverdi1, Nil Comunoglu4, Buge Oz4, Mustafa Uzan5. 1. Department of Neurosurgery, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. 2. Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. 3. Department of Neurosurgery, Fatih Sultan Mehmet Research and Education Hospital, Health Sciences University, Istanbul, Turkey. 4. Department of Pathology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. 5. Department of Neurosurgery, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: uzan@istanbul.edu.tr.
Abstract
INTRODUCTION: Recent ILAE classification defined focal cortical dysplasia (FCD) patients with accompanying epileptic lesions as a separate group. We investigated data of patients with sole FCD lesions regarding long-term seizure outcome and different characteristics of FCD type 1 and type 2 patients. METHODS: Eighty children and adult patients underwent surgery for FCD were included to the analysis of factors differentiating FCD type 1 and type 2 groups and their effect on long-term outcome. RESULTS: FCD type 2 patients had earlier epilepsy onset (8.1 vs. 6.1 years. p=0.019) and underwent surgery younger than type 1 (18.2 vs. 23.7 years. p=0.034). FCD type 2 patients were more prominently MR positive (77.8% vs. 53.8%. p=0.029), which increased within FCD type 2 group as patients become younger (p=0.028). FCD Type 1 lesions showed mostly multilobar extension and FCD type 2 mostly located in frontal lobe. Seizure freedom was achieved in 65.4% of FCD type 1 patients and 70.4% of FCD type 2 patients. Seven patients had permanent de novo neurological deficits. Mean follow-up time was 5.5 years (Range: 1-11 years). CONCLUSION: Surgical intervention in carefully selected patients may facilitate favorable seizure outcome leading to better quality of life. FCD type 1 and type 2 groups present with evident differences, which may promote medical and surgical management of these pathologies.
INTRODUCTION: Recent ILAE classification defined focal cortical dysplasia (FCD) patients with accompanying epileptic lesions as a separate group. We investigated data of patients with sole FCD lesions regarding long-term seizure outcome and different characteristics of FCD type 1 and type 2 patients. METHODS: Eighty children and adult patients underwent surgery for FCD were included to the analysis of factors differentiating FCD type 1 and type 2 groups and their effect on long-term outcome. RESULTS:FCD type 2 patients had earlier epilepsy onset (8.1 vs. 6.1 years. p=0.019) and underwent surgery younger than type 1 (18.2 vs. 23.7 years. p=0.034). FCD type 2 patients were more prominently MR positive (77.8% vs. 53.8%. p=0.029), which increased within FCD type 2 group as patients become younger (p=0.028). FCD Type 1 lesions showed mostly multilobar extension and FCD type 2 mostly located in frontal lobe. Seizure freedom was achieved in 65.4% of FCD type 1 patients and 70.4% of FCD type 2 patients. Seven patients had permanent de novo neurological deficits. Mean follow-up time was 5.5 years (Range: 1-11 years). CONCLUSION: Surgical intervention in carefully selected patients may facilitate favorable seizure outcome leading to better quality of life. FCD type 1 and type 2 groups present with evident differences, which may promote medical and surgical management of these pathologies.
Authors: D Mata-Mbemba; Y Iimura; L-N Hazrati; A Ochi; H Otsubo; O C Snead; J Rutka; E Widjaja Journal: AJNR Am J Neuroradiol Date: 2018-11-15 Impact factor: 3.825
Authors: Imad Najm; Dennis Lal; Mario Alonso Vanegas; Fernando Cendes; Iscia Lopes-Cendes; Andre Palmini; Eliseu Paglioli; Harvey B Sarnat; Christopher A Walsh; Samuel Wiebe; Eleonora Aronica; Stéphanie Baulac; Roland Coras; Katja Kobow; J Helen Cross; Rita Garbelli; Hans Holthausen; Karl Rössler; Maria Thom; Assam El-Osta; Jeong Ho Lee; Hajime Miyata; Renzo Guerrini; Yue-Shan Piao; Dong Zhou; Ingmar Blümcke Journal: Epilepsia Date: 2022-06-15 Impact factor: 6.740