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 journalArticlepeer-review

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

Keywords

  • cortical dysplasia
  • epilepsy surgery
  • neuropathology

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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