Analyze Of Surgery Treatment For Focal Cortical Dysplasia (FCD) Combining With Hippocampal Sclerosis (HS)

Purpose: The dual pathology epileptic patients are often present as intractableepilepsy. There are controversies when we are choosing the surgical treatment for them,especially for their focal cortical dysplasia (FCD) combine with hippocampal sclerosis(HS). In this article, we have seven patients who have been confirmed as dual pathologyafter surgery. We have made an analysis about them clinical and surgical treatmentcharacteristic..Material and methods: The chart of seven patients were chosen and analyzedretrospectively from patient database in our epilepsy center. All of the patients werediagnosed as FCD associated with HS from March of2009to April2012.Result: Three of them,whose magnetic resonance imaging (MRI) isnormal,resection of epileptogenic area according symptomatology, video-electroencephalography (VEEG) and electrocorticography (ECoG). While, the last offour patients whose MRI and VEEG have the uniformity location meaning resection theepileptogenic without ECoG. All of them have a good outcome.Conclusion: There three reasons for dual pathology epilepsy patients with MRInegative. The first one is the lower subtype of histopathology. The second one is that apart of clinical doctors don’t recognize this kind of histopathology clearly. The last oneis that the epileptic zone is too tiny. If the patient’s MRI is negative, we could locationthe epileptogenic zone(EZ) following the result of VEEG, ECoG and seizurecharacteristic. If the patient’s EZ has refer to function area, we could use ECoG to mapthe EZ and resection this area without impair the function of move, feel and language. While, if this EZ could not be resected, we could choose multiple subpial transection(MST) in order to reduce the chance of seizure.