J Korean Neurosurg Soc.  2019 May;62(3):321-327. 10.3340/jkns.2019.0005.

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

Affiliations
  • 1Department of Pediatrics, Dankook University Hospital, Cheonan, Korea.
  • 2Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 3Department of Pediatrics, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea. pednr@snu.ac.kr

Abstract

Focal cortical dysplasia (FCD) is the major cause of intractable focal epilepsy in childhood leading to epilepsy surgery. The overall seizure freedom after surgery ranges between 50-75% at 2 years after surgery and the long-term seizure freedom remain relatively stable. Seizure outcome after surgery depends on a various factors such as pathologic etiologies, extent of lesion, and types of surgery. Therefore, seizure outcome after surgery for FCD should be analyzed carefully considering cohorts' characteristics. Studies of pediatric epilepsy surgery emphasize the early surgical intervention for a better cognition. Early surgical intervention and cessation of seizure activity are important for children with intractable epilepsy. However, there are limited data on the cognitive outcome after surgery in pediatric FCD, requiring further investigation. This paper reviews the seizure and cognitive outcomes of epilepsy surgery for FCD in children. Several prognostic factors influencing seizure outcome after surgery will be discussed in detail.

Keyword

Malformations of cortical development; Pediatrics; Epilepsy; Surgery; Patient outcome assessment

MeSH Terms

Child
Cognition
Drug Resistant Epilepsy
Epilepsies, Partial
Epilepsy
Freedom
Humans
Malformations of Cortical Development*
Patient Outcome Assessment
Pediatrics
Seizures

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Reference

References

1. Aubert S, Wendling F, Regis J, McGonigal A, Figarella-Branger D, Peragut JC, et al. Local and remote epileptogenicity in focal cortical dysplasias and neurodevelopmental tumours. Brain. 132(Pt 11):3072–3086. 2009.
Article
2. Barkovich AJ, Kuzniecky RI, Dobyns WB, Jackson GD, Becker LE, Evrard P. A classification scheme for malformations of cortical development. Neuropediatrics. 27:59–63. 1996.
Article
3. Benifla M, Otsubo H, Ochi A, Snead OC 3rd, Rutka JT. Multiple subpial transections in pediatric epilepsy: indications and outcomes. Childs Nerv Syst. 22:992–998. 2006.
Article
4. Bjørnaes H, Stabell K, Henriksen O, Løyning Y. The effects of refractory epilepsy on intellectual functioning in children and adults. A longitudinal study. Seizure. 10:250–259. 2001.
Article
5. Blümcke I, Thom M, Aronica E, Armstrong DD, Vinters HV, Palmini A, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc task force of the ILAE diagnostic methods commission. Epilepsia. 52:158–174. 2011.
Article
6. Bulacio JC, Jehi L, Wong C, Gonzalez-Martinez J, Kotagal P, Nair D, et al. Long-term seizure outcome after resective surgery in patients evaluated with intracranial electrodes. Epilepsia. 53:1722–1730. 2012.
Article
7. Chen HH, Chen C, Hung SC, Liang SY, Lin SC, Hsu TR, et al. Cognitive and epilepsy outcomes after epilepsy surgery caused by focal cortical dysplasia in children: early intervention maybe better. Childs Nerv Syst. 30:1885–1895. 2014.
Article
8. Chern JJ, Patel AJ, Jea A, Curry DJ, Comair YG. Surgical outcome for focal cortical dysplasia: an analysis of recent surgical series. J Neurosurg Pediatr. 6:452–458. 2010.
Article
9. Choi SA, Kim SY, Kim H, Kim WJ, Kim H, Hwang H, et al. Surgical outcome and predictive factors of epilepsy surgery in pediatric isolated focal cortical dysplasia. Epilepsy Res. 139:54–59. 2018.
Article
10. Cohen-Gadol AA, Ozduman K, Bronen RA, Kim JH, Spencer DD. Long-term outcome after epilepsy surgery for focal cortical dysplasia. J Neurosurg. 101:55–65. 2004.
Article
11. Cossu M, Fuschillo D, Bramerio M, Galli C, Gozzo F, Pelliccia V, et al. Epilepsy surgery of focal cortical dysplasia-associated tumors. Epilepsia 54 Suppl. 9:115–122. 2013.
Article
12. Cossu M, Lo Russo G, Francione S, Mai R, Nobili L, Sartori I, et al. Epilepsy surgery in children: results and predictors of outcome on seizures. Epilepsia. 49:65–72. 2008.
Article
13. Cross JH, Jayakar P, Nordli D, Delalande O, Duchowny M, Wieser HG, et al. Proposed criteria for referral and evaluation of children for epilepsy surgery: recommendations of the subcommission for pediatric epilepsy surgery. Epilepsia. 47:952–959. 2006.
Article
14. Englot DJ, Breshears JD, Sun PP, Chang EF, Auguste KI. Seizure outcomes after resective surgery for extra-temporal lobe epilepsy in pediatric patients. J Neurosurg Pediatr. 12:126–133. 2013.
Article
15. Fauser S, Essang C, Altenmüller DM, Staack AM, Steinhoff BJ, Strobl K, et al. Long-term seizure outcome in 211 patients with focal cortical dysplasia. Epilepsia. 56:66–76. 2015.
Article
16. Freitag H, Tuxhorn I. Cognitive function in preschool children after epilepsy surgery: rationale for early intervention. Epilepsia. 46:561–567. 2005.
Article
17. Fujiwara H, Greiner HM, Lee KH, Holland-Bouley KD, Seo JH, Arthur T, et al. Resection of ictal high-frequency oscillations leads to favorable surgical outcome in pediatric epilepsy. Epilepsia. 53:1607–1617. 2012.
Article
18. Hader WJ, Mackay M, Otsubo H, Chitoku S, Weiss S, Becker L, et al. Cortical dysplastic lesions in children with intractable epilepsy: role of complete resection. J Neurosurg. 100(2 Suppl Pediatrics):110–117. 2004.
Article
19. Hamiwka L, Jayakar P, Resnick T, Morrison G, Ragheb J, Dean P, et al. Surgery for epilepsy due to cortical malformations: ten-year follow-up. Epilepsia. 46:556–560. 2005.
Article
20. Harvey AS, Cross JH, Shinnar S, Mathern GW, ILAE Pediatric Epilepsy Surgery Survey Taskforce. Defining the spectrum of international practice in pediatric epilepsy surgery patients. Epilepsia. 49:146–155. 2008.
Article
21. Hauptman JS, Mathern GW. Surgical treatment of epilepsy associated with cortical dysplasia: 2012 update. Epilepsia 53 Suppl. 4:98–104. 2012.
Article
22. Hirfanoglu T, Serdaroglu A, Kurt G, Erdem A, Capraz I, Bilir E, et al. Outcomes of resective surgery in children and adolescents with focal lesional epilepsy: the experience of a tertiary epilepsy center. Epilepsy Behav. 63:67–72. 2016.
Article
23. Hudgins RJ, Flamini JR, Palasis S, Cheng R, Burns TG, Gilreath CL. Surgical treatment of epilepsy in children caused by focal cortical dysplasia. Pediatr Neurosurg. 41:70–76. 2005.
Article
24. Jayakar P, Dunoyer C, Dean P, Ragheb J, Resnick T, Morrison G, et al. Epilepsy surgery in patients with normal or nonfocal MRI scans: Integrative strategies offer long-term seizure relief. Epilepsia. 49:758–764. 2008.
Article
25. Kim DW, Lee SK, Chu K, Park KI, Lee SY, Lee CH, et al. Predictors of surgical outcome and pathologic considerations in focal cortical dysplasia. Neurology. 72:211–216. 2009.
Article
26. Kloss S, Pieper T, Pannek H, Holthausen H, Tuxhorn I. Epilepsy surgery in children with focal cortical dysplasia (FCD): results of long-term seizure outcome. Neuropediatrics. 33:21–26. 2002.
Article
27. Kral T, Clusmann H, Blümcke I, Fimmers R, Ostertun B, Kurthen M, et al. Outcome of epilepsy surgery in focal cortical dysplasia. J Neurol Neurosurg Psychiatry. 74:183–188. 2003.
Article
28. Kral T, von Lehe M, Podlogar M, Clusmann H, Süssmann P, Kurthen M, et al. Focal cortical dysplasia: long term seizure outcome after surgical treatment. J Neurol Neurosurg Psychiatry. 78:853–856. 2007.
Article
29. Krsek P, Maton B, Jayakar P, Dean P, Korman B, Rey G, et al. Incomplete resection of focal cortical dysplasia is the main predictor of poor postsurgical outcome. Neurology. 72:217–223. 2009.
Article
30. Krsek P, Pieper T, Karlmeier A, Hildebrandt M, Kolodziejczyk D, Winkler P, et al. Different presurgical characteristics and seizure outcomes in children with focal cortical dysplasia type I or II. Epilepsia. 50:125–137. 2009.
Article
31. Lagarde S, Bonini F, McGonigal A, Chauvel P, Gavaret M, Scavarda D, et al. Seizure-onset patterns in focal cortical dysplasia and neurodevelopmental tumors: relationship with surgical prognosis and neuropathologic subtypes. Epilepsia. 57:1426–1435. 2016.
Article
32. Lerner JT, Salamon N, Hauptman JS, Velasco TR, Hemb M, Wu JY, et al. Assessment and surgical outcomes for mild type I and severe type II cortical dysplasia: a critical review and the UCLA experience. Epilepsia. 50:1310–1335. 2009.
Article
33. Marusic P, Najm IM, Ying Z, Prayson R, Rona S, Nair D, et al. Focal cortical dysplasias in eloquent cortex: functional characteristics and correlation with MRI and histopathologic changes. Epilepsia. 43:27–32. 2002.
Article
34. Mathern GW, Giza CC, Yudovin S, Vinters HV, Peacock WJ, Shewmon DA, et al. Postoperative seizure control and antiepileptic drug use in pediatric epilepsy surgery patients: the UCLA experience, 1986-1997. Epilepsia. 40:1740–1749. 1999.
Article
35. Mühlebner A, Gröppel G, Dressler A, Reiter-Fink E, Kasprian G, Prayer D, et al. Epilepsy surgery in children and adolescents with malformations of cortical development--outcome and impact of the new ILAE classification on focal cortical dysplasia. Epilepsy Res. 108:1652–1661. 2014.
Article
36. Munari T, Berta E, Francione S, Tassi L, Lo Russo G, Mai R, et al. Clinical ictal symptomatology and anatomical lesions: their relationships in severe partial epilepsy. Epilepsia 41 Suppl. 5:S18–S36. 2000.
Article
37. Nagarajan L, Lee M, Palumbo L, Lee S, Shah S, Walsh P, et al. Seizure outcomes in children with epilepsy after resective brain surgery. Eur J Paediatr Neurol. 19:577–583. 2015.
Article
38. Neyens LG, Aldenkamp AP, Meinardi HM. Prospective follow-up of intellectual development in children with a recent onset of epilepsy. Epilepsy Res. 34:85–90. 1999.
Article
39. Palmini A, Najm I, Avanzini G, Babb T, Guerrini R, Foldvary-Schaefer N, et al. Terminology and classification of the cortical dysplasias. Neurology. 62(6 Suppl 3):S2–S8. 2004.
Article
40. Phi JH, Cho BK, Wang KC, Lee JY, Hwang YS, Kim KJ, et al. Longitudinal analyses of the surgical outcomes of pediatric epilepsy patients with focal cortical dysplasia. J Neurosurg Pediatr. 6:49–56. 2010.
Article
41. Ramantani G, Kadish NE, Strobl K, Brandt A, Stathi A, Mayer H, et al. Seizure and cognitive outcomes of epilepsy surgery in infancy and early childhood. Eur J Paediatr Neurol. 17:498–506. 2013.
Article
42. Ramírez-Molina JL, Di Giacomo R, Mariani V, Deleo F, Cardinale F, Uscátegui-Daccarett AM, et al. Surgical outcomes in two different age groups with focal cortical dysplasia type II: any real difference? Epilepsy Behav. 70(Pt A):45–49. 2017.
Article
43. Roulet-Perez E, Davidoff V, Mayor-Dubois C, Maeder-Ingvar M, Seeck M, Ruffieux C, et al. Impact of severe epilepsy on development: recovery potential after successful early epilepsy surgery. Epilepsia. 51:1266–1276. 2010.
Article
44. Rowland NC, Englot DJ, Cage TA, Sughrue ME, Barbaro NM, Chang EF, et al. A meta-analysis of predictors of seizure freedom in the surgical management of focal cortical dysplasia. J Neurosurg. 116:1035–1041. 2012.
Article
45. Salanova V, Markand O, Worth R. Longitudinal follow-up in 145 patients with medically refractory temporal lobe epilepsy treated surgically between 1984 and 1995. Epilepsia. 40:1417–1423. 1999.
Article
46. Sevy A, Gavaret M, Trebuchon A, Vaugier L, Wendling F, Carron R, et al. Beyond the lesion: the epileptogenic networks around cavernous angiomas. Epilepsy Res. 108:701–708. 2014.
Article
47. Sisodiya SM. Surgery for malformations of cortical development causing epilepsy. Brain. 123(Pt 6):1075–1091. 2000.
Article
48. Skirrow C, Cross JH, Cormack F, Harkness W, Vargha-Khadem F, Baldeweg T. Long-term intellectual outcome after temporal lobe surgery in childhood. Neurology. 76:1330–1337. 2011.
Article
49. Tassi L, Colombo N, Garbelli R, Francione S, Lo Russo G, Mai R, et al. Focal cortical dysplasia: neuropathological subtypes, EEG, neuroimaging and surgical outcome. Brain. 125(Pt 8):1719–1732. 2002.
Article
50. Taylor DC, Falconer MA, Bruton CJ, Corsellis JA. Focal dysplasia of the cerebral cortex in epilepsy. J Neurol Neurosurg Psychiatry. 34:369–387. 1971.
Article
51. Téllez-Zenteno JF, Hernández Ronquillo L, Moien-Afshari F, Wiebe S. Surgical outcomes in lesional and non-lesional epilepsy: a systematic review and meta-analysis. Epilepsy Res. 89:310–318. 2010.
Article
52. Teutonico F, Mai R, Veggiotti P, Francione S, Tassi L, Borrelli P, et al. Epilepsy surgery in children: evaluation of seizure outcome and predictive elements. Epilepsia 54 Suppl. 7:70–76. 2013.
Article
53. Vingerhoets G. Cognitive effects of seizures. Seizure. 15:221–226. 2006.
Article
54. West S, Nolan SJ, Newton R. Surgery for epilepsy: a systematic review of current evidence. Epileptic Disord. 18:113–121. 2016.
Article
55. Widdess-Walsh P, Kellinghaus C, Jeha L, Kotagal P, Prayson R, Bingaman W, et al. Electro-clinical and imaging characteristics of focal cortical dysplasia: correlation with pathological subtypes. Epilepsy Res. 67:25–33. 2005.
Article
56. Wyllie E. Surgery for catastrophic localization-related epilepsy in infants. Epilepsia 37 Suppl. 1:S22–S25. 1996.
Article
57. Xue H, Cai L, Dong S, Li Y. Clinical characteristics and post-surgical outcomes of focal cortical dysplasia subtypes. J Clin Neurosci. 23:68–72. 2016.
Article
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