title: Taylor-type focal cortical dysplasia: is the epilepsy always resistant to medical treatment?
abstract: Patients with Taylor-type focal cortical dysplasia (TTFCD) generally present with medically intractable epilepsy and impaired neurological and/or intellectual functioning. Surgery usually proves to be the only treatment approach leading to control of seizures. We describe a 17-year-old girl with TTFCD who exhibited a very long period of seizure remission. Combined clinical and neuroimaging findings were compatible with a diagnosis of a balloon cell-subtype TTFCD. As for the clinical course, partial motor seizures began at one year of age and ceased at five: our patient has had no seizure recurrence over a 12-year-follow-up. Moreover, throughout the 15-year follow-up, neurological examinations and cognitive abilities always remained within normal limits. Neuropsychological assessment clearly showed no impairments in executive functions: planning abilities, working memory, attention and impulse control, or constructive aspects of motor coordination. The predominant deficits pertained to verbal abilities in the context of borderline intellectual performances. To our knowledge, this case report documents the longest duration of seizure remission in a patient with TTFCD, thus emphasizing the possible benign course of such dysplastic lesions which usually have a poor prognosis, leading to early surgical treatment.
authors.affiliation: Department of Pediatrics, Child Neurology Unit, Federico II University, Naples, Italy. endelgiu@unina.it
authors.forename: Ennio
authors.initials: E
authors.lastname: Del Giudice
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Bianchi
authors.forename: Michela
authors.initials: M
authors.lastname: Tosetti
authors.forename: Andrea
authors.initials: A
authors.lastname: Varrone
authors.forename: Alfonso
authors.initials: A
authors.lastname: Romano
authors.forename: Angela Francesca
authors.initials: AF
authors.lastname: Crisanti
authors.forename: Luigi
authors.initials: L
authors.lastname: Titomanlio
authors.forename: Floriana
authors.initials: F
authors.lastname: Imperati
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001288:Attention; D001921:Brain / Q000000981:diagnostic imaging; D002220:Carbamazepine / Q000627:therapeutic use*; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000473:pathology; D003071:Cognition; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000469:parasitology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008568:Memory; D010634:Phenobarbital / Q000627:therapeutic use; D011597:Psychomotor Performance; D011859:Radiography; D012075:Remission, Spontaneous; D012640:Seizures / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D010634:Phenobarbital