Outcome of Epilepsy Surgery for Extratemporal Focal Cortical Dysplasia

Document Type : Original Article

Authors

1 neurosurgery department , faculty of medicine, zagazig university , zagazig , egypt

2 Department of Neurosurgery Faculty of Medicine, Zagazig University,

3 Neurosurgery Department, Faculty of Medicine, Zagazig University

4 Neurosurgery department Zagazig University faculty of medicine Zagazig Egypt

Abstract

Background: Focal cortical dysplasia, a malformation of cortical development, is the most prevalent cause of drug-resistant epilepsy in children and the second or third most common cause in adults.

Aim: To analyze the outcome of resective surgery in the treatment of extra-temporal focal cortical dysplasia.

Methods: This study took place at department of neurosurgery at Zagazig University Hospitals and included thirty patients with extra temporal focal cortical dysplasia treated by resective surgery using intra operative electro coticography.

Results: Our study showed that 60% of patients had right sided lesions. About 46.6% had frontal lobe lesion, 6.7%, 10% and 36.6% had occipital lobe lesion, parietal lobe lesion, and multi-lobar lesion respectively. In our study histopathological analysis showed that FCD type I in 9 patients (30%) and FCD type II in 21 patients (70%). In our study we found that 83.4% of patients passed uncomplicated.10% with general complications (UTI, chest infection, Electrolyte disturbance) which managed conservatively and 6.6% with regional complications (small hematoma and superficial infection) which managed conservatively. As regard outcome evaluated by Engel classification about 83.4% had class I, 10%, 3.3%, 3.3% had class II, III and Class IV respectively.

Conclusion: Surgery achieves seizure freedom in about 65% of cases of FCD. Complete resection of the FCD is the most important prognostic factor of seizure freedom. Subtotal resection, longer duration of seizures before surgery, occurrence of secondarily generalized seizures and multilobar FCD are negative predictors.

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Zagazig University Medical Journal

Articles in Press, Accepted Manuscript
Available Online from 23 April 2024

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