Abstracts

Rationale: Focal cortical dysplasia (FCD) is a malformation of cortical development, which is the most common etiology in children and the third most frequent findings in adults undergoing epilepsy surgery. The aim of this study is to analyze the epileptic seizures in FCD.Methods: Between September 2012 and January 2015, patients who diagnosed with FCD were collected. We divided our patients into two groups. Group 1 was patients who received epilepsy surgery with pathology-proven FCD. Group 2 was patients who showed evident FCD on the brain MRI, but did not receive epilepsy surgery. We excluded patients diagnosed with pachygyria, polymicrogyria, hemimegalencephaly, lissencephaly, heterotopia, tuberous sclerosis complex, isolated brain tumor, isolated mesial temporal sclerosis, and isolated hippocampal sclerosis. Clinical seizure semiology and treatment outcome were analyzed.Results: 64 patients, 34 males and 30 females, were enrolled. 39 patients were categorized as group 1, and 25 were group 2. 29 patients (45.3%) exhibited focal epilepsy, 30 (46.9%) manifested focal epilepsy with or without evolving to bilateral convulsive seizures, 5 (7.8%) presented with epileptic spasms evolving to focal epilepsy. The findings of interictal EEG varied from nonspecific finding of background slowing to specific findings of various epileptiform discharges. The appearance of FCD on serial MRI after maturation of myelination was found. In group 1 patients, the seizure outcomes after epilepsy surgery showed 24 patients (61.5%) achieved Engel I seizure outcome, 6 (15.4%) were Engel II, 4 (10.3%) were Engel III, and 5(12.8%) were Engel IV.Conclusions: FCDs should be included to be one of differential diagnoses of intractable epilepsies in infants and children, as well as in adulthood. Surgical treatment offers a promising therapy option in these patients.