Long-term seizure outcome in 211 patients with focal cortical dysplasia

Epilepsia ◽  
2014 ◽  
Vol 56 (1) ◽  
pp. 66-76 ◽  
Author(s):  
Susanne Fauser ◽  
Charles Essang ◽  
Dirk-Matthias Altenmüller ◽  
Anke Maren Staack ◽  
Bernhard J. Steinhoff ◽  
...  
Keyword(s):  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome

scholarly journals Long-term seizure outcome in pediatric patients with focal cortical dysplasia undergoing tailored and standard surgical resections

Seizure ◽  
2018 ◽  
Vol 62 ◽  
pp. 66-73 ◽  
Author(s):  
Eva Martinez-Lizana ◽  
Susanne Fauser ◽  
Armin Brandt ◽  
Elisabeth Schuler ◽  
Gert Wiegand ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome

scholarly journals Focal cortical dysplasia: long term seizure outcome after surgical treatment

2007 ◽  
Vol 78 (8) ◽  
pp. 853-856 ◽  
Author(s):  
T Kral ◽  
M von Lehe ◽  
M Podlogar ◽  
H Clusmann ◽  
P Sussmann ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome

scholarly journals Commentary on long-term seizure outcome in 211 patients with focal cortical dysplasia

Epilepsia ◽  
2015 ◽  
Vol 56 (7) ◽  
pp. 1176-1177 ◽  
Author(s):  
Marco Giulioni ◽  
Matteo Martinoni ◽  
Gianluca Marucci
Keyword(s):  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome

scholarly journals Long‐term seizure outcome after epilepsy surgery in patients with mild malformation of cortical development and focal cortical dysplasia

2018 ◽  
Vol 4 (1) ◽  
pp. 170-175 ◽  
Author(s):  
Tim J. Veersema ◽  
Banu Swampillai ◽  
Cyrille H. Ferrier ◽  
Pieter Eijsden ◽  
Peter H. Gosselaar ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Focal Cortical Dysplasia ◽  
Cortical Development ◽  
Cortical Dysplasia ◽  
Seizure Outcome ◽  
Malformation Of Cortical Development

Epilepsy Surgery in Children with Focal Cortical Dysplasia (FCD): Results of Long-Term Seizure Outcome

2002 ◽  
Vol 33 (1) ◽  
pp. 21-26 ◽  
Author(s):  
S. Kloss ◽  
T. Pieper ◽  
H. Pannek ◽  
H. Holthausen ◽  
I. Tuxhorn
Keyword(s):  
Epilepsy Surgery ◽  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome

Predictors of postoperative long-term seizure outcome in pediatric patients with focal cortical dysplasia type II at a German tertiary epilepsy center

2021 ◽  
pp. 1-9
Author(s):  
Abdallah Salemdawod ◽  
Johannes Wach ◽  
Mohammed Banat ◽  
Valeri Borger ◽  
Motaz Hamed ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Pediatric Patients ◽  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Complete Resection ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Type Ii ◽  
Younger Age

OBJECTIVE Focal cortical dysplasia (FCD) is a common cause of early-onset intractable epilepsy, and resection is a highly sufficient treatment option. In this study, the authors aimed to provide a retrospective analysis of pre- and postoperative factors and their impact on postoperative long-term seizure outcome. METHODS The postoperative seizure outcomes of 50 patients with a mean age of 8 ± 4.49 years and histologically proven FCD type II were retrospectively analyzed. Furthermore, pre- and postoperative predictors of long-term seizure freedom were assessed. The seizure outcome was evaluated based on the International League Against Epilepsy (ILAE) classification. RESULTS Complete resection of FCD according to MRI criteria was achieved in 74% (n = 37) of patients. ILAE class 1 at the last follow-up was achieved in 76% (n = 38) of patients. A reduction of antiepileptic drugs (AEDs) to monotherapy or complete withdrawal was achieved in 60% (n = 30) of patients. Twelve patients (24%) had a late seizure recurrence, 50% (n = 6) of which occurred after reduction of AEDs. A lower number of AEDs prior to surgery significantly predicted a favorable seizure outcome (p = 0.013, HR 7.63). Furthermore, younger age at the time of surgery, shorter duration of epilepsy prior to surgery, and complete resection were positive predictors for long-term seizure freedom. CONCLUSIONS The duration of epilepsy, completeness of resection, number of AEDs prior to surgery, and younger age at the time of surgery served as predictors of postoperative long-term seizure outcome, and, as such, may improve clinical practice when selecting and counseling appropriate candidates for resective epilepsy surgery. The study results also underscored that epilepsy surgery should be considered early in the disease course of pediatric patients with FCD type II.

scholarly journals In response: Long-term seizure outcome in 211 patients with focal cortical dysplasia

Epilepsia ◽  
2015 ◽  
Vol 56 (7) ◽  
pp. 1177-1178 ◽  
Author(s):  
Susanne Fauser ◽  
Andreas Schulze-Bonhage
Keyword(s):  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome

Long-term outcome after epilepsy surgery for focal cortical dysplasia

2004 ◽  
Vol 101 (1) ◽  
pp. 55-65 ◽  
Author(s):  
Aaron A. Cohen-Gadol ◽  
Korey Özduman ◽  
Richard A. Bronen ◽  
Jung H. Kim ◽  
Dennis D. Spencer
Keyword(s):  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome ◽  
Epileptogenic Zone ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Content Type ◽  
The Mean ◽  
Fine Print

Object. Reports of outcomes for surgical treatment of cortical dysplasia associated with epilepsy are conflicting due to the inclusion of patients with a wide range of malformations of cortical development. The authors report their experience and the long-term outcome for a subgroup of patients with the histopathological diagnosis of focal cortical dysplasia of Taylor. Methods. The records of 22 patients with focal cortical dysplasia of Taylor (15 with the balloon-cell type and seven with the nonballoon-cell type) were reviewed. There were 11 female and 11 male patients whose mean age was 26 ± 17.6 years (mean ± standard deviation [SD]) at surgery. The details of their epilepsy evaluation and resection were analyzed. Extent of resection was preoperatively planned using information obtained from long-term intracranial monitoring (15 patients) and/or more definitively determined by histopathologically proven clear margins during resection when feasible (12 patients). The mean duration of follow up was 6.3 ± 5.1 years (mean ± SD, range 0.5–15.6 years). Risk factors for epilepsy were trauma (seven patients) or meningoencephalitis (one patient); 14 patients (64%) had no obvious risk factors. The mean age at seizure onset was 9.2 years and the mean duration of their epilepsy was 16.1 ± 9 years. In two patients there were no adverse findings on magnetic resonance (MR) imaging. In 15 patients (68%), the epileptogenic zone identified on long-term intracranial monitoring extended beyond the abnormality observed on MR images. Focal resection (lesion plus margins) was performed in 14 patients (64%), whereas eight (36%) underwent partial/tailored lobectomy. Two patients underwent multiple subpial transections in addition to partial lesionectomy because their lesions involved the sensorimotor cortex. In these two, functional MR imaging confirmed a normal functional anatomy despite the presence of the cortical dysplasia. Eleven (92%) of 12 patients who underwent resection guided by histopathologically proven clear margins and three (43%) of seven patients who underwent histopathologically proven subtotal resection have remained seizure free. Evidence of clear margins was significantly associated with an improved seizure outcome (p = 0.003). Postoperatively, expected deficits included nondisabling visual field defects, which occurred in three patients (14%), and transient sensorimotor deficits, which appeared in five (23%). Two patients had meningitis, which was successfully treated with antibiotics. Overall, 16 patients (73%) are either seizure free (13 patients), have rare nondisabling partial seizures (one patient), or had one seizure after their medication was changed (two patients). Thirteen patients (59%) have discontinued anticonvulsant medications or are being maintained on monotherapy. Of five patients (23%), two have had rare disabling seizures or significant reduction in their seizure frequency (three patients). One patient's seizures have remained the same. Conclusions. Focal cortical dysplasias are a distinct subgroup of malformations of cortical development and have a favorable outcome after resection. The epileptogenic zone often extends beyond the abnormality found on neuroimaging. Resection of the epileptogenic zone guided by histopathologically proven clear margins is associated with an improved seizure outcome.

scholarly journals Seizure outcome following primary motor cortex-sparing resective surgery for perirolandic focal cortical dysplasia

2016 ◽  
Vol 36 ◽  
pp. 466-476 ◽  
Author(s):  
Siby Gopinath ◽  
Arun Grace Roy ◽  
Kollencheri Puthenveetil Vinayan ◽  
Anand Kumar ◽  
Manjit Sarma ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Primary Motor Cortex ◽  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Seizure Outcome ◽  
Resective Surgery

Seizure Outcome After Surgery for MRI-Diagnosed Focal Cortical Dysplasia: A Systematic Review and Meta-analysis

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013066
Author(s):  
Anna Willard ◽  
Ana Antonic-Baker ◽  
Zhibin Chen ◽  
Terence John O'Brien ◽  
Patrick Kwan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Focal Cortical Dysplasia ◽  
Meta Analysis ◽  
Cortical Dysplasia ◽  
Favorable Outcome ◽  
Seizure Outcome ◽  
Drug Resistant ◽  
Resective Surgery ◽  
Post Surgery ◽  
Drug Resistant Epilepsy

Objective:Focal cortical dysplasia (FCD) has been associated with poorer post-surgical seizure outcomes compared to other pathologies. FCD surgical series have been assembled on the basis of a histological diagnosis, including patients with abnormal as well as normal pre-operative MRI. However, in clinical workflow, patient selection for surgery is based on pre-operative findings, including MRI. We performed a systematic review and meta-analysis of the literature to determine the rate and predictors of favorable seizure outcome after surgery for MRI-detected FCD.Methods:We devised our study protocol in accordance with PRISMA guidelines and registered the protocol with PROSPERO. We searched MEDLINE, EMBASE, and Web of Science for studies of patients followed for ≥12 months after resective surgery for drug-resistant epilepsy with MRI-detected FCD. Random-effects meta-analysis was used to calculate the proportion of patients attaining a favorable outcome, defined as Engel Class I, ILAE Classes 1-2, or “seizure-free” status. Meta-regression was performed to investigate sources of heterogeneity.Results:Our search identified 3,745 references. Of these, 35 studies (total of 1,353 patients) were included. Most studies (89%) followed patients for ≥24 months post-surgery. The overall post-surgical favorable outcome rate was 70% (95% CI: 64-75). There was high inter-study heterogeneity. Favorable outcome was associated with complete resection of the FCD lesion [risk ratio, RR=2.42 (95% CI: 1.55-3.76), p<0.001] and location of the FCD lesion in the temporal lobe [RR=1.38 (95% CI: 1.07-1.79), p=0013], but not lesion extent, intracranial EEG use, or FCD histological type. The number of FCD histological types included in the same study accounted for 7.6% of the observed heterogeneity.Conclusions:70% of patients with drug-resistant epilepsy and MRI features of FCD attain a favorable seizure outcome following resective surgery. Our findings can be incorporated in routine pre-operative counselling and reinforce the importance of resecting completely the MRI-detected FCD where this is safe and feasible.

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