Focal cortical dysplasia. Clinical-radiological-pathological associations.
BACKGROUND
The term focal cortical dysplasia (FCD) describes a particular migration disorder with a symptomatology mainly characterised by drug-resistant epileptic seizures, typical neuroradiological images, and histological characteristics, as well as a very positive response to surgical treatment in the majority of cases.


METHODS
A total of 7 patients were studied, comprising 6 children with a mean age of 34.3 months and one 25-year-old male with very persistent focal seizures and MRI images that showed FCD.


RESULTS
Three of the patients (all girls) were operated on while very young, with extirpation of the FCD and the surrounding area; with the histopathology study showed agreement between the MRI images and the macroscopic study of the slices. The histology study showed findings typical of a Taylor-type FCD (poor differentiation between the cortical grey matter and the subcortical white matter, and balloon cells). Three years after the FCD extirpation, the same 3 patients remained seizure-free with no anti-epilepsy medication. Two others have seizure control with medication, another (the adult) is on the surgical waiting list, and the remaining patient refused the operation.


CONCLUSIONS
Taylor-type FCD is associated with a high percentage of all drug-resistant focal seizures, and it needs to be identified and extirpated as soon as possible. Well planned and well-performed surgery that leaves no remains of dysplasia can cure the disease it in many cases.
Servicio de Neurología Pediátrica, Hospital Universitario La Paz, Madrid, España. i.pcastroviejo@neurologia.e.telefonica.net
I
I
Pascual-Castroviejo
J L
JL
Hernández-Moneo
M L
ML
Gutiérrez-Molina
J
J
Viaño
S I
SI
Pascual-Pascual
R
R
Velazquez-Fragua
C
C
Morales
D
D
Quiñones
D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000000981:diagnostic imaging* / Q000523:psychology* / Q000601:surgery; D019635:Neurosurgical Procedures; D049268:Positron-Emission Tomography; D011859:Radiography; D012640:Seizures / Q000209:etiology; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D055815:Young Adult