Surgical Outcomes Of Focal Cortical Dysplasia:A Follow-up Study Of 102 Patients

Objective:To explore the prognostic factors for seizure control in focal cortical dysplasia(FCD)by analyzing the clinical features of children and adolescents with FCD.Methods: We conducted a follow-up study of patients,who were confirmed FCD by pathology after resective surgery,in Epileptic Center,Guangdong Sanjiu Brain Hospital,From January 1,2014 to December 31,2014.All patients were followed at least 6 months,they were divided into seizure control group(Engel class I)and seizure group(Engel class II-class IV)according to Surgical outcomes.Clinical features,auxiliary examinations,and Pathological classification were compared between two groups.Results:102 Patients were included,male 65 cases(63.7%),female 37 cases(36.3%),onset age 0.01-45 years old,average 10.3 years old,surgery age 3 years old-47 years old,average 21.21 years old,all had seizure onset.83(81.4%)patients in seizure control group,19(18.6%)patients in seizure group.There are 14.5% of the patients' onset ages are younger than 3 years old,59.8% preoperative electroencephalogram recording a diffusion epileptiform discharge,32.5% orientation of magnetic resonance imaging(MRI)and electroencephalography(EEG)is inconsistent,49.4% postoperative electroencephalogram(EEG)reveal an epileptiform discharge,45.2% of the patients had intellectual disability,36.1% had an absence of a lesion on MRI,in seizure control group.however,in seizure group they respectively 36.8%,89.5%,94.1%,89.5%,89.5%,68.4%.patients in seizure control group got an average scores of 89.4 in performance intelligence quotient(PIQ)test,while,seizure group 65.80 there has a statistical significance between two groups.Conclusion Postoperative seizure outcome was favorable in patients with FCD,onset ages younger 3 years old,intellectual disability,getting a lower scores in PIQ test,preoperative electroencephalogram recording a diffusion epileptic discharge,inconsistent orientation of MRI and EEG,and postoperative EEG reveal an epileptiform discharge may be predictive for the postoperative outcome.