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Surgery for focal cortical dysplasia in children using intraoperative mapping

Child's Nervous System volume 30, pages 1839–1851 (2014)Cite this article

Abstract

Objective

Children with malformation of cortical development represent a significant proportion of pediatric epilepsy surgery candidates. Here, we describe a single-center experience with pediatric patients who underwent surgery for intractable epilepsy due to focal cortical dysplasia (FCD).

Methods

Clinical data of 78 patients under 18 years of age with diagnosis of intractable epilepsy due to FCD who underwent surgery from January 1996 to January 2012 were reviewed comparing data of patients submitted to electrocorticography (ECoG) with those without ECoG.

Results

Patients’ mean age at surgery was 8.52 ± 4.99 years; mean age at epilepsy onset was 2.55 ± 3.01 years. Almost 80 % of the patients underwent ECoG register that was essential for delimitation of surgical resection in 66 out of 78 patients. ECoG was performed in all patients with extratemporal lesions, and the most common FCD found was type II. Seizure outcome was similar in groups with or without ECoG.

Conclusions

Tailored resection of FCD lesions for intractable epilepsy can be safely performed in children with a good seizure outcome and low complication rate. Epilepsy surgery should be considered for all patients with FCD and refractory epilepsy.

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Affiliations

  1. Centro de Cirurgia de Epilepsia (CIREP), Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Sao Paulo, Brazil

    Vera C. Terra, Ursula Thomé, Sara S. Rosset, Sandra S. Funayama, Antonio Carlos dos Santos, Marcelo Volpon dos Santos, Américo C. Sakamoto & Helio R. Machado

  2. Setor de Epilepsia e EEG, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Paraná, Curitiba, Parana, Brazil

    Vera C. Terra

Authors
  1. Vera C. Terra
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  2. Ursula Thomé
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  3. Sara S. Rosset
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  4. Sandra S. Funayama
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  5. Antonio Carlos dos Santos
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  6. Marcelo Volpon dos Santos
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  7. Américo C. Sakamoto
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  8. Helio R. Machado
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Correspondence to Vera C. Terra.

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Terra, V.C., Thomé, U., Rosset, S.S. et al. Surgery for focal cortical dysplasia in children using intraoperative mapping. Childs Nerv Syst 30, 1839–1851 (2014). https://doi.org/10.1007/s00381-014-2459-7

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  • DOI: https://doi.org/10.1007/s00381-014-2459-7

Keywords

  • Focal cortical dysplasia
  • Epilepsy
  • Children
  • Electrocorticography