Signification Of Multimodal Assessment System In Epileptic Patients Associated With Focal Cortical Dysplasia

Objective: Surgery is an effective method for the treatment of focal cortical dysplasia-related epilepsy,but the success rate of surgery varies from high to low.In this study,we proposed the multimodal assessment system,and applied it to guide the operation of epileptic patients associated with focal cortical dysplasia.We analyzed the value of multimodal assessment system in improving the prognosis of epileptic patients associated with focal cortical dysplasia.Methods: Patients who underwent surgical treatment at the Second Hospital of Lanzhou University from October 2016 to November 2018 and whose pathology was confirmed to be focal cortical dysplasia were selected.All patients were evaluated by multimodal system during the perioperative period and then determined the surgical method.After more than 4 months of follow-up,the postoperative outcome was evaluated by the ILAE Engel criteria.Engel?was defined as good,Engel?~?was defined as poor.Combining literature and statistics to analyze the value of multimodal assessment system in the treatment of focal cortical dysplasia.The patient's lesion location,imaging findings,pathological type,EEG results,complications,etc.were analyzed,and the relationship between the good group and the poor group was analyzed.Results: All the 22 patients underwent surgical resection.The average follow-up time was 16.4�9.0(4-28 months,median 16.5 months).Seventeen patients with epilepsy control reached Engel?grade,and 5 patients achieved Engel?grade,1patient achieved Engel ? grade,and 1 patient achieved Engel ? grade.The overall good rate is 81.8%.There were 9 females(40.9%)and 13 males(59.1%).Fourteen patients(63.6%)had abnormalities in MRI;There were 14 patients with lesions all located in temporal lobe,and 8 cases were involved in temporal lobe.According to theclassification proposed by International League Against Epilepsy in 2011,the pathology was divided into three types,including 7 cases of FCD ? type,5 cases of FCD ? type,10 cases of FCD ? type.One of the 22 patients developed intracranial infection and recovered from hospital discharge.One patient had visual acuity after surgery,and one patient had obvious brain swelling after operation.The decompressive surgery was performed with decompressive craniectomy.The remaining patients had no complications.Fisher's exact test results show that disease duration,EEG-clinical characteristics-anatomical localization consistency may be factors influencing the efficacy of FCD surgery.Age,lesion location,gender,histopathology type,and MRI findings had no significant effect on prognosis.Conclusion: Multimodal assessment system can more accurately locate epileptogenic areas of patients with focal cortical dysplasia,provide a scientific theoretical basis for epilepsy surgery,and significantly improve the prognosis of patients;Multimodal and multiparameter assessment can complement each other,learn from each other's strengths and complement each other's weaknesses,which is a comprehensive and accurate assessment method.