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Low-grade focal cortical dysplasia is associated with prenatal and perinatal brain injury
P. Krsek, A. Jahodova, B. Maton, P. Jayakar, P. Dean, B. Korman, G. Rey, C. Dunoyer, HV. Vinters, T. Resnick, M. Duchowny
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, práce podpořená grantem
NLK
Free Medical Journals
od 1997 do Před 1 rokem
Wiley Online Library (archiv)
od 1997-01-01 do 2012-12-31
Wiley Free Content
od 1997
- MeSH
- dítě MeSH
- dospělí MeSH
- elektroencefalografie MeSH
- epilepsie parciální diagnóza patologie chirurgie MeSH
- hemisferektomie metody MeSH
- inteligenční testy MeSH
- kojenec MeSH
- lidé MeSH
- magnetická rezonanční tomografie statistika a číselné údaje MeSH
- malformace mozkové kůry diagnóza patologie chirurgie MeSH
- mladiství MeSH
- mozek patologie chirurgie MeSH
- mozková kůra patologie chirurgie MeSH
- neuropsychologické testy MeSH
- předoperační péče metody MeSH
- předškolní dítě MeSH
- prenatální diagnóza MeSH
- rizikové faktory MeSH
- těhotenství MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: Prenatal and perinatal adverse events are reported to have a pathogenetic role in focal cortical dysplasia (FCD). However, no data are available regarding the prevalence and significance of this association. A cohort of children with significant prenatal and perinatal brain injury and histologically proven mild malformations of cortical development (mMCD) or FCD was analyzed. METHODS: We retrospectively evaluated a surgical series of 200 patients with histologically confirmed mMCD/FCD. Combined historical and radiologic inclusion criteria were used to identify patients with prenatal and perinatal risk factors. Electroclinical, imaging, neuropsychological, surgical, histopathologic, and seizure outcome data were reviewed. RESULTS: Prenatal and perinatal insults including severe prematurity, asphyxia, bleeding, hydrocephalus, and stroke occurred in 12.5% of children with mMCD/FCD (n = 25). Their epilepsy was characterized by early seizure onset, high seizure frequency, and absence of seizure control. Patients with significant prenatal and perinatal risk factors had more abnormal neurologic findings, lower intelligence quotient (IQ) scores, and slower background EEG activity than mMCD/FCD subjects without prenatal or perinatal brain injury. MRI evidence of cortical malformations was identified in 74% of patients. Most patients underwent large multilobar resections or hemispherectomies; 54% were seizure-free 2 years after surgery. Histologically "milder" forms of cortical malformations (mMCD and FCD type I) were observed most commonly in our series. CONCLUSIONS: Surgically remediable low-grade cortical malformations may occur in children with significant prenatally and perinatally acquired encephalopathies and play an important role in the pathogenesis of their epilepsy. Presurgical detection of dysplastic cortex has important practical consequences for surgical planning.
Department of Neurology University of Miami Miller School of Medicine Miami Florida U S A
Pathology and Laboratory Medicine and Neurology Los Angeles California U S A
Citace poskytuje Crossref.org
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