title: Surgical outcome of cortical dysplasias presenting with chronic intractable epilepsy: a 10-year experience.
abstract: BACKGROUND
  There has been sparse description of cortical dysplasias (CDs) causing intractable epilepsy from India.
  
  
  OBJECTIVE
  Clinical retrospective study of CDs causing intractable epilepsy that underwent surgery.
  
  
  METHODS
  Fifty-seven cases of CDs reviewed (1995 till July 2006) are presented. All patients had intractable epilepsy, and underwent a complete epilepsy surgery workup (inter ictal electroencephalography (EEG), video EEG, MRI as per epilepsy protocol, SPECT {interictal, ictal with subtraction and co-registration when required}, and PET when necessary). Surgical treatment included a wide exposure of the pathology with a detailed electrocorticography under optimal anesthetic conditions. Mapping of the sensori-motor area was performed where indicated. Procedures included resection either alone or combined with multiple subpial transactions when extending into the eloquent areas.
  
  
  RESULTS
  Our study had 28 (49.12%) cases of isolated focal CDs, and 29 (50.67%) with dual pathology. Average age at the time of onset of seizures in our series was 7.04 years (three months to 24 years), and average age at the time of surgery was 10.97 years (eight months to 45 years). Among coexistent pathologies, one had associated MTS, 16 had coexistent gangliogliomas and 12 (dysembryonic neuroepithelial tumor) DNTs. At an average follow-up of 3.035 years (range 5-10 years), three patients were lost to follow-up. Fifty-one per cent (29/57) patients had a good outcome (Engel Grade I) and 26%(15/57) had a Grade II outcome.
  
  
  CONCLUSIONS
  Cortical dysplasias have a good outcome if evaluated and managed with concordant electrical and imaging modalities.
authors.affiliation: Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Manjari
authors.initials: M
authors.lastname: Tripathi
authors.forename: Mahendra S
authors.initials: MS
authors.lastname: Singh
authors.forename: M V
authors.initials: MV
authors.lastname: Padma
authors.forename: Shailesh
authors.initials: S
authors.lastname: Gaikwad
authors.forename: C S
authors.initials: CS
authors.lastname: Bal
authors.forename: Madhavi
authors.initials: M
authors.lastname: Tripathi
authors.forename: C
authors.initials: C
authors.lastname: Sarkar
authors.forename: Aditya
authors.initials: A
authors.lastname: Gupta
authors.forename: Garima
authors.initials: G
authors.lastname: Shukla
authors.forename: V P
authors.initials: VP
authors.lastname: Singh
authors.forename: Satish
authors.initials: S
authors.lastname: Jain
authors.forename: Bhawani S
authors.initials: BS
authors.lastname: Sharma
authors.forename: P Sarat
authors.initials: PS
authors.lastname: Chandra
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D005260:Female; D038421:Hemispherectomy / Q000379:methods*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult