title: Taylor's focal cortical dysplasia increases the risk of sleep-related epilepsy.
abstract: OBJECTIVE
  To analyze the topography of the epileptogenic zone (EZ) and the etiologic substrate as risk factors for sleep-related focal epilepsy.
  
  
  METHODS
  Three hundred three patients (172 males and 131 females, mean age at surgery 25.6 +/- 13.1 years), who were seizure-free after resective surgery for drug-resistant focal epilepsy, were retrospectively reviewed. Statistical analysis was conducted to evaluate the risk of presenting sleep-related epilepsy (SRE) against topography of resection (assumed to correspond or to include the EZ) and results of histology.
  
  
  RESULTS
  Thirty-nine patients (12.8%) presented with an SRE. At bivariate analysis, a higher frequency of SRE was associated with a frontal lobe EZ (p = 1.94 x 10(-9)) and Taylor's FCD (TFCD, p = 2.20 x 10(-16)), whereas architectural FCD (p = 0.00977), ganglioglioma (p = 0.02508), and mesial temporal sclerosis (p = 2.47 x 10(-5)) were correlated with a reduced frequency of SRE. Multivariate analysis demonstrated that the only variable significantly associated with SRE was the presence of a TFCD, which increased 14-fold the risk of SRE [p = 1.66 x 10(-10); risk ratio (RR) = 14.44].
  
  
  CONCLUSIONS
  In this study, we have demonstrated a significant and strong association between SRE and TFCD in a select population of patients with drug-resistant focal epilepsy submitted to surgical resection of the EZ. Although our results cannot be applied to the entire spectrum of SRE, the presence of TFCD as the underlying etiology should be considered when evaluating patients with SRE, because surgery can provide excellent results on seizures in these cases.
authors.affiliation: Claudio Munari Epilepsy Surgery Center, Sleep Medicine Center, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 320162 Milan, Italy. lino.nobili@ospedaleniguarda.it
authors.forename: Lino
authors.initials: L
authors.lastname: Nobili
authors.forename: Francesco
authors.initials: F
authors.lastname: Cardinale
authors.forename: Umberto
authors.initials: U
authors.lastname: Magliola
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cicolin
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Didato
authors.forename: Manuela
authors.initials: M
authors.lastname: Bramerio
authors.forename: Dalila
authors.initials: D
authors.lastname: Fuschillo
authors.forename: Roberto
authors.initials: R
authors.lastname: Spreafico
authors.forename: Roberto
authors.initials: R
authors.lastname: Mai
authors.forename: Ivana
authors.initials: I
authors.lastname: Sartori
authors.forename: Stefano
authors.initials: S
authors.lastname: Francione
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lo Russo
authors.forename: Laura
authors.initials: L
authors.lastname: Castana
authors.forename: Laura
authors.initials: L
authors.lastname: Tassi
authors.forename: Massimo
authors.initials: M
authors.lastname: Cossu
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology* / Q000601:surgery; D015897:Comorbidity; D018572:Disease-Free Survival; D004351:Drug Resistance; D004569:Electroencephalography / Q000379:methods / Q000706:statistics & numerical data; D004828:Epilepsies, Partial / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D054220:Malformations of Cortical Development / Q000453:epidemiology* / Q000473:pathology*; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012598:Sclerosis / Q000473:pathology; D020178:Sleep Disorders, Circadian Rhythm / Q000453:epidemiology* / Q000473:pathology