title: Type II focal cortical dysplasia: electroclinical study and surgical outcome in 31 pediatric patients.
abstract: OBJECTIVE
  The aim of this study was to analyze the electroclinical features and surgical outcome of 31 pediatric patients with focal cortical dysplasia (FCD) type II.
  
  
  METHODS
  We conducted a retrospective, descriptive study of 31 patients with FCD type II followed between 1998 and 2011. We included patients with FCD type II confirmed by histopathological examination with abnormal magnetic resonance imaging and at least 1 year of follow-up.
  
  
  RESULTS
  All patients had severe focal epilepsy; in infancy, four of them had also had epileptic spasms, associated with hypsarrhythmia in three. Focal status epilepticus occurred in five patients (16 %) and epilepsia partialis continua in one (3.2 %). Seizures occurred during sleep in 20 (64.5 %) and in clusters in 19 (61.3 %) patients. Neurological examination showed a mild motor deficit in seven (22.8 %) patients. Interictal abnormalities were characterized by rhythmic spikes and polyspike discharges, increasing during sleep in 13 (41.9 %) patients. Average time of follow-up after surgery was 4.7 years with a median time of 4 years and a range from 1 to 9 years. Engel classification class I was found in 20 (67.7 %) and class II in 3 cases (9.6 %). There were no significant changes after an average time of follow-up of 4.7 years.
  
  
  CONCLUSIONS
  Our results confirm that surgery is the best treatment option for pediatric patients with refractory focal epilepsy due to type II FCD. A statistically significant correlation was found between a good prognosis and age at epilepsy onset older than 2 years.
authors.affiliation: Neurology Unit-Epilepsy Group, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Combate de los Pozos 1881, CP 1245, Buenos Aires, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Noli
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bartuluchi
authors.forename: Federico Sanchez
authors.initials: FS
authors.lastname: González
authors.forename: María Carolina
authors.initials: MC
authors.lastname: Kaltenmeier
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cersosimo
authors.forename: Carlos
authors.initials: C
authors.lastname: Rugilo
authors.forename: Juan P
authors.initials: JP
authors.lastname: Princich
authors.forename: Fabiana
authors.initials: F
authors.lastname: Lubieniecki
authors.forename: Hugo
authors.initials: H
authors.lastname: Pomata
authors.forename: Roberto
authors.initials: R
authors.lastname: Caraballo
mesh_terms: D000293:Adolescent; D001927:Brain Diseases / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D004827:Epilepsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D065703:Malformations of Cortical Development, Group I; D019635:Neurosurgical Procedures / Q000592:standards*; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome