Type i focal cortical dysplasia: Surgical outcome is related to histopathology

Laura Tassi, Rita Garbelli, Nadia Colombo, Manuela Bramerio, Giorgio Lo Russo, Francesco Deleo, Gloria Milesi, Roberto Spreafico

Research output: Contribution to journalArticle

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Abstract

Pre-surgical and post-surgical data were examined and compared from 215 consecutive patients undergoing surgery for intractable epilepsy. Patients were selected on the basis of a proven histopathological diagnosis of type I focal cortical dysplasia (FCD I), alone or associated with other lesions. The patients were divided into five sub-groups: i) 66 with isolated FCD I, ii) 76 with FCD I and hippocampal sclerosis, iii) 49 with FCD I and tumours, iv) 16 with FCD I and other malformations of cortical development and v) eight with FCD I and anoxic-ischaemic or inflammatory diseases. The duration of epilepsy was greatest in patients with FCD I associated with hippocampal sclerosis, and those with isolated FCD I showed the highest seizure frequency at the time of surgery. Hippocampal sclerosis and tumours were the most frequent pathological lesions associated with FCD I in temporal lobe epilepsy. Febrile seizures significantly correlated with the presence of hippocampal sclerosis and FCD I. Isolated FCD I was observed in 31% of the patients, characterized by frequent seizures, negative magnetic resonance imaging, and frequent frontal or multilobar involvement. In comparison to patients with FCD I associated with hippocampal sclerosis, MCD or tumours, the patients with isolated FCD I had a worse post-surgical outcome (46% in class I). Our findings indicate that there is a high incidence of FCD I associated with other apparently distinct pathologies, particularly those affecting the temporal lobe, and highlight the need for a comprehensive clinicopathological approach for the classification of FCD I.

Original languageEnglish
Pages (from-to)181-191
Number of pages11
JournalEpileptic Disorders
Volume12
Issue number3
DOIs
Publication statusPublished - Sep 2010

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Malformations of Cortical Development
Sclerosis
Seizures
Febrile Seizures
Neoplasms
Temporal Lobe Epilepsy
Temporal Lobe

Keywords

  • cortical dysplasia
  • epilepsy surgery
  • neuropathology

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Tassi, L., Garbelli, R., Colombo, N., Bramerio, M., Lo Russo, G., Deleo, F., ... Spreafico, R. (2010). Type i focal cortical dysplasia: Surgical outcome is related to histopathology. Epileptic Disorders, 12(3), 181-191. https://doi.org/10.1684/epd.2010.0327

Type i focal cortical dysplasia : Surgical outcome is related to histopathology. / Tassi, Laura; Garbelli, Rita; Colombo, Nadia; Bramerio, Manuela; Lo Russo, Giorgio; Deleo, Francesco; Milesi, Gloria; Spreafico, Roberto.

In: Epileptic Disorders, Vol. 12, No. 3, 09.2010, p. 181-191.

Research output: Contribution to journalArticle

Tassi, L, Garbelli, R, Colombo, N, Bramerio, M, Lo Russo, G, Deleo, F, Milesi, G & Spreafico, R 2010, 'Type i focal cortical dysplasia: Surgical outcome is related to histopathology', Epileptic Disorders, vol. 12, no. 3, pp. 181-191. https://doi.org/10.1684/epd.2010.0327
Tassi, Laura ; Garbelli, Rita ; Colombo, Nadia ; Bramerio, Manuela ; Lo Russo, Giorgio ; Deleo, Francesco ; Milesi, Gloria ; Spreafico, Roberto. / Type i focal cortical dysplasia : Surgical outcome is related to histopathology. In: Epileptic Disorders. 2010 ; Vol. 12, No. 3. pp. 181-191.
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