Surgical outcome and prognostic factors of pediatric epilepsy caused by cortical dysplasia

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Park, C. K.; Kim, S. K.; Wang, K. C.; Hwang, Y. S.; Kim, K. J.; Chae, J. H.; Chi, J. G.; Choe, G. Y.; Kim, N. R.; Cho, B. K.
Issue Date
American Association for Cancer Research
Childs Nerv Syst 22:586-592
AdolescentBrain Diseases/complications/*surgeryCerebral Cortex/*abnormalities/*surgeryChildChild, PreschoolElectroencephalographyEpilepsy/etiology/pathology/*surgeryFemaleFollow-Up StudiesHumansInfantMagnetic Resonance ImagingMalePositron-Emission TomographyPrognosisRetrospective StudiesTomography, Emission-Computed, Single-Photon*Treatment Outcome
OBJECTS: We analyzed 30 patients with cortical dysplasia (CD) and epilepsy to evaluate the clinical characteristics and surgical outcome of both epilepsy control and neurocognition. MATERIALS AND METHODS: The mean ages at seizure onset and at the time of the operation were 3.6 years (range, 1 month-12.6 years) and 10.3 years (range, 1.5-18.3 years), respectively. The mean follow-up period was 3.2 years (range, 1-5.3 years). (18)FDG-positron emission tomography was the most sensitive and magnetic resonance imaging was the most specific in localizing the lesion. Developmental/intellectual delay was predominant in the early-onset group (n=18, seizure onset <3 years), with intelligence tending to be normal in the late-onset group (n=12, seizure onset >or=3 years). Mild CD predominated in the late-onset epilepsy group and moderate or severe CD in the early-onset group (p=0.005). The surgical success rate of epilepsy control was 87%. A better outcome was obtained if the lesion was confined to the temporal lobe. School performance was favorable in 43%. The age at seizure onset and preoperative developmental/intellectual delay were the important prognostic factors in school performance as well as the epilepsy control. A total of 77% of patients had relatively good social adaptation. Successful epilepsy control and good school performance were affirmative conditions precedent to social adaptation. CONCLUSIONS: Due to the favorable control of epilepsy and its effect on school performance and social adaptation, surgical treatment is strongly recommended for cortical dysplasia and intractable epilepsy.
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College of Medicine/School of Medicine (의과대학/대학원)Pathology (병리학전공)Journal Papers (저널논문_병리학전공)
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