Surgical treatment of pediatric focal cortical dysplasia

Hye Eun Kwon, Soyong Eom, Hoon Chul Kang, Joon Soo Lee, Se Hoon Kim, Dong Seok Kim, Heung Dong Kim

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: To analyze the clinical presentation and outcomes of surgically treated focal cortical dysplasia (FCD) in children. Methods: We reviewed 75 cases of confirmed FCD by pathology after resective surgery. We used the pathologic classification proposed by the International League Against Epilepsy and included clinical profile and seizure and neurodevelopmental outcomes in analyses. Results: There were 11 cases of FCD type I, 34 of type IIa, 19 of type IIb, and 11 of type III. Fiftyone cases (68.0%) presented clinically as focal epilepsy (FE) and 24 (32.0%) as epileptic encephalopathy (EE), including 16 with Lennox-Gastaut syndrome and 8 with West syndrome. We observed EE in 7 cases (63.6%) in FCD type I, 14 (41.2%) in type IIa, 2 (10.5%) in type IIb, and 1 (9.1%) in type III. We found the following more frequently in EE: seizure onset occurring at younger than 2 years (EE: 20 [83.3%], FE: 19 [37.3%]; p < 0.001), presence of intellectual disability before surgery (EE: 22 [91.7%], FE: 29 [56.9%]; p = 0.003), and multilobar resections (EE: 19 [79.2%], FE: 15 [29.4%]; p < 0.001). Forty-eight cases (64.0%) were seizure-free; 66.7% (34/51) in FE, 58.3% (14/24) in EE. Neurodevelopmental level showed more improvement (11/48 vs 0/27, p = 0.011) and less deterioration (2/48 vs 9/27, p = 0.001) in the seizurefree group compared to the non-seizure-free group. Conclusions: FCD can cause FE and EE in pediatric age, and resective surgery should be considered as a treatment option for both types of epilepsy.

Original languageEnglish
Pages (from-to)945-951
Number of pages7
JournalNeurology
Volume87
Issue number9
DOIs
Publication statusPublished - 2016 Aug 30

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Malformations of Cortical Development
Brain Diseases
Partial Epilepsy
Pediatrics
Epilepsy
Therapeutics
Seizures
Infantile Spasms
Intellectual Disability
Pathology

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Kwon, Hye Eun ; Eom, Soyong ; Kang, Hoon Chul ; Lee, Joon Soo ; Kim, Se Hoon ; Kim, Dong Seok ; Kim, Heung Dong. / Surgical treatment of pediatric focal cortical dysplasia. In: Neurology. 2016 ; Vol. 87, No. 9. pp. 945-951.
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abstract = "Objective: To analyze the clinical presentation and outcomes of surgically treated focal cortical dysplasia (FCD) in children. Methods: We reviewed 75 cases of confirmed FCD by pathology after resective surgery. We used the pathologic classification proposed by the International League Against Epilepsy and included clinical profile and seizure and neurodevelopmental outcomes in analyses. Results: There were 11 cases of FCD type I, 34 of type IIa, 19 of type IIb, and 11 of type III. Fiftyone cases (68.0{\%}) presented clinically as focal epilepsy (FE) and 24 (32.0{\%}) as epileptic encephalopathy (EE), including 16 with Lennox-Gastaut syndrome and 8 with West syndrome. We observed EE in 7 cases (63.6{\%}) in FCD type I, 14 (41.2{\%}) in type IIa, 2 (10.5{\%}) in type IIb, and 1 (9.1{\%}) in type III. We found the following more frequently in EE: seizure onset occurring at younger than 2 years (EE: 20 [83.3{\%}], FE: 19 [37.3{\%}]; p < 0.001), presence of intellectual disability before surgery (EE: 22 [91.7{\%}], FE: 29 [56.9{\%}]; p = 0.003), and multilobar resections (EE: 19 [79.2{\%}], FE: 15 [29.4{\%}]; p < 0.001). Forty-eight cases (64.0{\%}) were seizure-free; 66.7{\%} (34/51) in FE, 58.3{\%} (14/24) in EE. Neurodevelopmental level showed more improvement (11/48 vs 0/27, p = 0.011) and less deterioration (2/48 vs 9/27, p = 0.001) in the seizurefree group compared to the non-seizure-free group. Conclusions: FCD can cause FE and EE in pediatric age, and resective surgery should be considered as a treatment option for both types of epilepsy.",
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Surgical treatment of pediatric focal cortical dysplasia. / Kwon, Hye Eun; Eom, Soyong; Kang, Hoon Chul; Lee, Joon Soo; Kim, Se Hoon; Kim, Dong Seok; Kim, Heung Dong.

In: Neurology, Vol. 87, No. 9, 30.08.2016, p. 945-951.

Research output: Contribution to journalArticle

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T1 - Surgical treatment of pediatric focal cortical dysplasia

AU - Kwon, Hye Eun

AU - Eom, Soyong

AU - Kang, Hoon Chul

AU - Lee, Joon Soo

AU - Kim, Se Hoon

AU - Kim, Dong Seok

AU - Kim, Heung Dong

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N2 - Objective: To analyze the clinical presentation and outcomes of surgically treated focal cortical dysplasia (FCD) in children. Methods: We reviewed 75 cases of confirmed FCD by pathology after resective surgery. We used the pathologic classification proposed by the International League Against Epilepsy and included clinical profile and seizure and neurodevelopmental outcomes in analyses. Results: There were 11 cases of FCD type I, 34 of type IIa, 19 of type IIb, and 11 of type III. Fiftyone cases (68.0%) presented clinically as focal epilepsy (FE) and 24 (32.0%) as epileptic encephalopathy (EE), including 16 with Lennox-Gastaut syndrome and 8 with West syndrome. We observed EE in 7 cases (63.6%) in FCD type I, 14 (41.2%) in type IIa, 2 (10.5%) in type IIb, and 1 (9.1%) in type III. We found the following more frequently in EE: seizure onset occurring at younger than 2 years (EE: 20 [83.3%], FE: 19 [37.3%]; p < 0.001), presence of intellectual disability before surgery (EE: 22 [91.7%], FE: 29 [56.9%]; p = 0.003), and multilobar resections (EE: 19 [79.2%], FE: 15 [29.4%]; p < 0.001). Forty-eight cases (64.0%) were seizure-free; 66.7% (34/51) in FE, 58.3% (14/24) in EE. Neurodevelopmental level showed more improvement (11/48 vs 0/27, p = 0.011) and less deterioration (2/48 vs 9/27, p = 0.001) in the seizurefree group compared to the non-seizure-free group. Conclusions: FCD can cause FE and EE in pediatric age, and resective surgery should be considered as a treatment option for both types of epilepsy.

AB - Objective: To analyze the clinical presentation and outcomes of surgically treated focal cortical dysplasia (FCD) in children. Methods: We reviewed 75 cases of confirmed FCD by pathology after resective surgery. We used the pathologic classification proposed by the International League Against Epilepsy and included clinical profile and seizure and neurodevelopmental outcomes in analyses. Results: There were 11 cases of FCD type I, 34 of type IIa, 19 of type IIb, and 11 of type III. Fiftyone cases (68.0%) presented clinically as focal epilepsy (FE) and 24 (32.0%) as epileptic encephalopathy (EE), including 16 with Lennox-Gastaut syndrome and 8 with West syndrome. We observed EE in 7 cases (63.6%) in FCD type I, 14 (41.2%) in type IIa, 2 (10.5%) in type IIb, and 1 (9.1%) in type III. We found the following more frequently in EE: seizure onset occurring at younger than 2 years (EE: 20 [83.3%], FE: 19 [37.3%]; p < 0.001), presence of intellectual disability before surgery (EE: 22 [91.7%], FE: 29 [56.9%]; p = 0.003), and multilobar resections (EE: 19 [79.2%], FE: 15 [29.4%]; p < 0.001). Forty-eight cases (64.0%) were seizure-free; 66.7% (34/51) in FE, 58.3% (14/24) in EE. Neurodevelopmental level showed more improvement (11/48 vs 0/27, p = 0.011) and less deterioration (2/48 vs 9/27, p = 0.001) in the seizurefree group compared to the non-seizure-free group. Conclusions: FCD can cause FE and EE in pediatric age, and resective surgery should be considered as a treatment option for both types of epilepsy.

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