Different presurgical characteristics and seizure outcomes in children with focal cortical dysplasia type I or II
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
18513354
DOI
10.1111/j.1528-1167.2008.01682.x
PII: EPI1682
Knihovny.cz E-resources
- MeSH
- Atrophy pathology MeSH
- Child MeSH
- Electroencephalography MeSH
- Fluorodeoxyglucose F18 MeSH
- Glial Fibrillary Acidic Protein metabolism MeSH
- Hippocampus pathology MeSH
- Immunohistochemistry MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Malformations of Cortical Development epidemiology metabolism pathology MeSH
- Antibodies, Monoclonal metabolism MeSH
- Postoperative Care MeSH
- Preoperative Care * MeSH
- Radiopharmaceuticals MeSH
- Retrospective Studies MeSH
- Age of Onset MeSH
- Treatment Outcome MeSH
- Seizures epidemiology surgery MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Fluorodeoxyglucose F18 MeSH
- Glial Fibrillary Acidic Protein MeSH
- Antibodies, Monoclonal MeSH
- Radiopharmaceuticals MeSH
PURPOSE: Cortical dysplasia (FCD) is a frequent cause of epilepsy in childhood. Two major pathological variants are distinguished, FCD type I and II. The aim of the study was to characterize differences between FCD type I and II with respect to imaging and EEG findings, clinical and neuropsychological presentations, and surgical outcome. METHODS: Forty children with refractory epilepsy and histopathologically confirmed FCD were retrospectively analyzed. FCD type I was identified in 24 and FCD type II in 16 patients. RESULTS: Characteristic MRI abnormalities in FCD type I included subtle white matter signal changes and regional reduction of the white matter volume. Typical MRI findings in FCD type II were increased cortical thickness, transmantle sign, gray-white matter junction blurring, fluid-attenuated inversion recovery (FLAIR) and proton density (PD) gray matter signal changes as well as T1w, and PD white matter signal changes. Continuous EEG slowing was significantly more common in patients with FCD type I. Children with FCD type I presented with lower levels of intelligence and were suffering more often from maladaptive behavior and behavioral disorders. Surgical outcome was significantly worse in the FCD type I group (seizure freedom was achieved in 21% FCD type I patients and in 75% FCD type II subjects, p < 0.001). CONCLUSIONS: Clinically important differences were found in children with distinct histopathological subtypes of FCD. Due to prominent neuropsychological deficits and worse seizure outcome, treatment strategies in FCD type I are more challenging than previously reported and these children should be recognized and specifically addressed within the incoherent group of patients with malformative brain disorders.
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