Long-term Outcome And Prognostic Factors In Focal Cortical Dysplasia With Refractory Epilepsy

Objective:To analyze the surgical outcome and relevant surgical prognostic factors including gender,pathological subtype,MRI results,the age at surgery,the location of epileptogenic zone,the resection extent of epileptogenic zone in focal cortical dysplasia(FCD)with refractory epilepsy.Methods: We analyzed the profiles of the 97 patients with histologically proven FCD from 2007.5 to 2015.11 in Department of Neurosurgery,Xuanwu Hospital,Capital Medical University.We retrospectively analyzed the relationship between gender,pathological subtype,MRI results,the age at surgery,the location of epileptogenic zone,the resection extent of epileptogenic zone and the surgical outcome in these patients.Results: The mean follow-up month in 97 patients was 59.18±28.62(range from 15 months to 119 months,median month 65).Among them,male counted up to 61 with the percentage of 62.89% while female counted up to 36 with percentage of 37.11%.60 patients(61.86%)belong to Engel I 11 patients(11.34%)belong to Engel II.16 patients(16.49%)belong to Engel III while 10 patients(10.31%)belong to Engel IV.We consider the 60 patients with Engel I classification as favorable outcome while the rest three groups are unfavorable outcome.Then we divided the prognostic factors into each separate group just as MRI negative(For those who couldn't been detected by MRI scan)and MRI positive(For those who can been detected by MRI scan),age at surgery < 18 and ?18,totally resection and partially resection,epileptogenic zone located at temporal lobe and extratemporal lobe.For FCD classification,we divided them into FCD I,II and III according to the new International League Against Epilepsy(ILAE)guidelines.We analyzed the profiles and the results are as follow: the outcome of postoperative FCD patients is in relationship with the MRI results,the age at surgery and the resection extent of epileptogenic zone.There is no significant statistical relationship in gender,the location of epileptogenic zone and FCD classification.There were about 59% patients belonging to favorable outcome 5 years after surgery.Conclusion: Younger age at surgery(<18),MRI positive and totally resection of epileptogenic zone are the favorable prognosis factors for FCD patients with drug-resistant epilepsy.There is no significant statistical relationship in gender,the location of epileptogenic zone and FCD classification.There were about 59% patients belonging to favorable outcome 5 years after surgery.