title: Seizure outcome of infantile spasms with focal cortical dysplasia.
abstract: OBJECTIVE
  This study sought to evaluate the seizure outcome of infantile spasms (IS) with focal cortical dysplasia (FCD).
  
  
  METHODS
  We retrospectively reviewed infantile spasms patients with FCD from 2004 to 2010. We investigated seizure outcome from antiepileptic drug (AED), ketogenic diet (KD), resective surgery, and analyzed the results according to individual imaging studies.
  
  
  RESULTS
  Among 404 patients of IS, FCD was confirmed in 51 patients. In retrospective review of brain MRI, only 21 patients (41.2%) were suspected of FCD before 1year of age, but 45 patients (88.2%) became confirmed to FCD by MRI after the age of 1year. Once the spasms were not controlled by 1 or 2 AEDs, the chance of becoming seizure free with additional third or more drugs was very low (2.3%). The seizure free rate was 33.3% (7/21) in patients treated with ketogenic diet, and 73.3% (22/30) in surgical patients, who were both intractable to AEDs. There were no significant differences in seizure free rate in both ketogenic diet and surgical patients, between MRI negative and positive patients prior to 1year of age.
  
  
  CONCLUSIONS
  KD and surgery should be considered in medically refractory IS with FCD.
authors.affiliation: Department of Pediatrics, Chungnam Naional University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
authors.forename: Joon Won
authors.initials: JW
authors.lastname: Kang
authors.forename: Seon Kyeong
authors.initials: SK
authors.lastname: Rhie
authors.forename: Rita
authors.initials: R
authors.lastname: Yu
authors.forename: Soyong
authors.initials: S
authors.lastname: Eom
authors.forename: William
authors.initials: W
authors.lastname: Hong
authors.forename: Shin Hye
authors.initials: SH
authors.lastname: Kim
authors.forename: Hoon-Chul
authors.initials: HC
authors.lastname: Kang
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Young-Mock
authors.initials: YM
authors.lastname: Lee
authors.forename: Heung Dong
authors.initials: HD
authors.lastname: Kim
mesh_terms: D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging / Q000379:methods; D004569:Electroencephalography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D054220:Malformations of Cortical Development / Q000601:surgery*; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000601:surgery*; D016896:Treatment Outcome
keywords: Epilepsy surgery; Focal cortical dysplasia; Infantile spasms; Ketogenic diet