Surgery for epilepsy due to cortical malformations: ten-year follow-up.
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.
Hamiwka
Lorie
L
Alberta Children's Hospital, Calgary, Alberta, Canada.
Jayakar
Prasanna
P
Resnick
Trevor
T
Morrison
Glenn
G
Ragheb
John
J
Dean
Patricia
P
Dunoyer
Catalina
C
Duchowny
Michael
M
D000293:Adolescent; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000473:pathology / Q000601:surgery; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome