Document Detail


Focal cortical dysplasia: long term seizure outcome after surgical treatment.
MedLine Citation:
PMID:  17287239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Studies of long term outcome after epilepsy surgery for cortical malformations are rare. In this study, we report our experience with surgical treatment and year to year long term outcome for a subgroup of patients with focal cortical dysplasia (FCD). METHODS: We retrospectively analysed the records of 49 patients (females n = 26; males n = 23; mean age 25 (11) years) with a mean duration of epilepsy of 18 years (range 1-45). Preoperative MRI, histological results based on the Palmini classification and clinical year to year follow-up according to the International League Against Epilepsy (ILAE) classification were available in all patients. RESULTS: 98% of patients had a lesion on preoperative MRI. In addition to lobectomy (n = 9) or lesionectomy (n = 40), 14 patients had multiple subpial transections of the eloquent cortex. The resected tissue was classified as FCD type II b in 41 cases with an extratemporal (88%) and FCD type II a in 8 cases with a temporal localisation (100%). After a mean follow-up of 8.1 (4.5) years, 37 patients (76%) were seizure free, a subgroup of 23 patients (47%) had been completely seizure free since surgery (ILAE class 1a) and 4 patients (8%) had only auras (ILAE class 2). Over a 10 year follow-up, the proportion of satisfactory outcomes decreased, mainly within the first 3 years. During long term follow-up, 48% stopped antiepileptic drug treatment, 34% received a driver's license and 57% found a job or training. CONCLUSION: Surgical treatment of epilepsy with FCD is not only successful in the short term but also has a satisfying long term outcome which remains constant after 3 years of follow-up but is not associated with better employment status or improvement in daily living.
Authors:
T Kral; M von Lehe; M Podlogar; H Clusmann; P Süssmann; M Kurthen; A Becker; H Urbach; J Schramm
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Publication Detail:
Type:  Journal Article     Date:  2007-02-07
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  78     ISSN:  1468-330X     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-19     Completed Date:  2007-09-10     Revised Date:  2010-09-15    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  853-6     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Bonn, Medical Centre, Sigmund Freud Strasse 25, 53105 Bonn, Germany. Thomas.Kral@ukb.uni-bonn.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cerebral Cortex / pathology*
Epilepsy / surgery*
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Retrospective Studies
Treatment Outcome
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