Address of Corresponding Author

Pediatric Neurosurgery 2005;41:70-76 (DOI: 10.1159/000085159)

  Key Words

• Focal cortical dysplasia
• Epilepsy
• Magnetic resonance imaging
• Frameless stereotaxy

  Abstract

Focal cortical dysplasia (FCD) is a congenital disorder of neuronal migration that is increasingly recognized as a common cause of seizures in children, occurring in 20-30% of all surgically treated cases of epilepsy in the pediatric population. Advances in neuroimaging have contributed to recognition of FCD. We report 15 children (9 female, 6 male) with FCD and surgically treated intractable epilepsy. In 9 cases, a surgical strategy of anatomic (frameless stereotactic) grid placement and physiologic (electrocorticography) resection was employed. Postoperative MRI scans were obtained, the pathologic specimen was graded according to the Brannstrom system, and seizure outcome was defined using the Engel classification. There were no deaths and no permanent morbidity. After, on average, 4 years since treatment, 10 children are seizure free, 2 are 2A, 2 are 2B and 1 is 3A. Predictors of good outcome are an MRI-defined lesion and increased cortical disorganization (higher Brannstrom grade). Subtotal resection did not preclude a seizure-free outcome.

Copyright © 2005 S. Karger AG, Basel

  Author Contacts

Roger J. Hudgins, MD
5455 Meridian Mark Rd.
Suite 540
Atlanta, GA 30342 (USA)
Tel. +1 404 255 6509, Fax +1 404 255 1686, E-Mail rjhudgins@pediatricneurosurgery.net

  Article Information

Received: June 11, 2004
Accepted after revision: September 15, 2004
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 2, Number of References : 26