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Predictors of surgical outcome and pathologic considerations in focal cortical dysplasia

Cited 122 time in Web of Science Cited 138 time in Scopus
Authors
Kim, D. W.; Lee, S. K.; Chu, K.; Park, K. I.; Lee, C. H.; Choe, G.; Kim, J. Y.; Chung, C. K.; Lee, S. Y.
Issue Date
2009-01-20
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
NEUROLOGY; Vol.72 3; 211-216
Abstract
Background: Although surgical resection has been an important alternative treatment for patients with intractable epilepsy related to focal cortical dysplasia (FCD), the prognostic relevance of the degree of pathologic severity is controversial and there has been only limited information regarding the prognostic factors involved in the surgical treatment of refractory epilepsy in patients with FCD. Methods: We undertook the present study to assess whether the pathologic subtypes of FCD affect surgical outcomes in patients with drug-resistant epilepsy. We also studied the prognostic roles of clinical factors and various diagnostic modalities in the surgical treatment. Results: A total of 166 consecutive patients were included. By univariate analysis, incomplete resection of epileptogenic area (p < 0.001), mild pathologic features (p = 0.01), and the presence of secondary tonic clonic seizures (2GTCS) (p = 0.05) were associated with poor surgical outcomes. There was a strong tendency for patients with severe pathologic features to have MRI abnormalities (p < 0.001). Incomplete resection of epileptogenic area (p < 0.001) and mild pathologic features (p = 0.02) were poor independent outcome predictors on multivariate analysis. The results of MRI, scalp EEG, fluorodeoxyglucose-PET, and ictal SPECT were not associated with surgical outcomes. Conclusions: Our study shows that there is a strong tendency for patients with severe pathologic features to have MRI abnormalities, and patients with incomplete resection, mild pathologic features, or the presence of secondary tonic clonic seizures have a high chance of a poorer surgical outcome. Neurology (R) 2009;72:211-216
ISSN
0028-3878
Language
English
URI
http://hdl.handle.net/10371/77448
DOI
https://doi.org/10.1212/01.wnl.0000327825.48731.c3
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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