Surgery for Epilepsy Due to Cortical Malformations: Ten‐year Follow‐up

• Published in: Epilepsia (Copenhagen) 2005-04, Vol.46 (4), p.556-560
• Main Authors: Hamiwka, Lorie, Jayakar, Prasanna, Resnick, Trevor, Morrison, Glenn, Ragheb, John, Dean, Patricia, Dunoyer, Catalina, Duchowny, Michael
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Cerebral Cortex - abnormalities; Cerebral Cortex - pathology; Cerebral Cortex - surgery; Child; Child, Preschool; Cortical malformation; Electroencephalography; Epilepsies, Partial - diagnosis; Epilepsies, Partial - pathology; Epilepsies, Partial - surgery; Epilepsy; Epilepsy, Temporal Lobe - pathology; Epilepsy, Temporal Lobe - surgery; Female; Follow-Up Studies; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Infant; Longitudinal Studies; Magnetic Resonance Imaging; Male; Malformations of the nervous system; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Outcome; Prognosis; Retrospective Studies; Spasms, Infantile - pathology; Spasms, Infantile - surgery; Surgery; Temporal Lobe - pathology; Temporal Lobe - surgery; Treatment Outcome; Tumors of the nervous system. Phacomatoses
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.0013-9580.2005.52504.x

Children with malformations of cortical development represent a significant proportion of pediatric epilepsy surgery candidates. From a cohort of 40 children operated on between 1980 and 1992 with malformation of cortical development, 38 were alive and had data 10 years after surgery. Age at surgery ranged from 6 months to 18 years (mean, 9.6 years). Thirty‐six had partial seizures, and two had infantile spasms; 20 were nonlesional. Pathologic diagnoses were cortical dysplasia (n = 31) and developmental tumor (n = 7). At 10‐year follow‐up, 15 (40%) were seizure free, 10 (26%) had >90% seizure reduction, and 13 (34%) were improved or unchanged. Children seizure free at two‐year follow‐up were likely to remain seizure free. Ten‐year seizure freedom was 72% in children with developmental tumors and 32% in the cortical dysplasia group. Complete resection was statistically significant for favorable outcome, and no patient with an incomplete resection was seizure free.