All issues > Volume 44(5); 2001

Original Article

J Korean Pediatr Soc. 2001;44(5):552-561. Published online May 15, 2001.

Surgically Treated Intractable Child Epilepsy with Focal Cortical Dysplasia : Clinical and Electroencephalographic Findings

So Hee SH Chung¹, Ho Young HY Lee¹, Mun Hyang MH Lee¹, Hye Kyung HK Yoon², Bo Kyung BK Kim², Seung Chyul SC Hong³

¹Departments of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
²Departments of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
³Departments of Neurosurgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea

Correspondence Mun Hyang MH Lee ,Email: mhlee@smc.samsung.co.kr

Abstract

Purpose
: Widespread use of MRI now gives us increased insights into the different expressions of cortical malformations. We carried out this study to characterize the clinical and EEG features of focal cortical dysplasia(FCD) which also caused intractable epilepsy requiring surgical treatment.
Methods
: A retrospective analysis was conducted in 8 children. The history of seizures, imaging studies, electroencephalographic findings, pathologic results, and surgical outcomes were reviewed.
Results
: The onset ages of clinical seizure were from 4 days after birth to 36 months. The frequency of seizures were from multiple times a day to a few times a month. Five out of 8 FCD patients had global developmental delays with more degrees of delay in language. Only 2 out of 8 patients showed clinical partial seizures only. The scalp EEG disclosed localized interictal epileptiform activity in all 8 patients and localized continuous slow waves in 7 out of 8 patients. Ictal scalp EEG onset demonstrated a predominantly localized EEG seizure activity in 6 patients. Ictal invasive EEG findings were variable in each patient and the patterns of ictal EEG were demonstrated. Five out of 8 patients became seizure-free. One patient had one episode of seizure during the 16 months follow up period. Two patients did not have significant relief from seizures.
Conclusion
: The patients with FCD had varied spectrums of clinical manifestation, MRI and EEG findings. Five out of 8 FCD patients had complete relief from seizures, one patient has had one short, simple, partial seizure since surgery, but 2 patients with FCD in the frontal area did not experience significant relief from seizures.

Keywords :Focal cortical dysplasia, Intractable epilepsy, Electroencephalography