Dysplasia: a common finding in intractable pediatric temporal lobe epilepsy.
BACKGROUND
Risk factors for temporal lobe epilepsy (TLE) include history of CNS infection, family history of epilepsy, and history of febrile convulsions (FC). Pre-existing cortical dysplasia (CD) may also predispose to refractory TLE, independent of other risk factors for epilepsy.


METHODS
The authors reviewed the neuropathologic features of surgical tissue from temporal lobectomies of 33 pediatric patients with refractory TLE, with and without a history of epilepsy risk factors.


RESULTS
CD was found in 64% (21/33) of all patients with refractory TLE, including 73% (11/15) patients with a history of FC, 66% (2/3) patients with CNS infections, and 83% (5/6) patients with a family history of epilepsy. Disrupted cortical lamination, dystrophic and maloriented neurons, and balloon cells characterized the CD found in the temporal neocortex.


CONCLUSIONS
CD was seen in 21 of 33 surgical specimens from children with refractory TLE, including those with and without other epilepsy risk factors.
Porter
B E
BE
Pediatric Regional Epilepsy Program, Children's Hospital of Philadelphia, and Department of Pediatrics and Neurology, University of Pennsylvania School of Medicine, Philadelphia 19104, USA. Porterb@email.chop.edu
Judkins
A R
AR
Clancy
R R
RR
Duhaime
A
A
Dlugos
D J
DJ
Golden
J A
JA
D001927:Brain Diseases / Q000150:complications / Q000473:pathology*; D015984:Causality; D002648:Child; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008297:Male; D019579:Neocortex / Q000473:pathology*; D012307:Risk Factors; D016896:Treatment Outcome