Focal cortical dysplasia. Clinical-radiological-pathological associations

Neurologia. 2012 Oct;27(8):472-80. doi: 10.1016/j.nrl.2011.10.012. Epub 2012 Jan 2.
[Article in English, Spanish]

Abstract

Introduction: 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.

Material and 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.

Conclusion: 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.

MeSH terms

  • Child
  • Child, Preschool
  • Electroencephalography
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Malformations of Cortical Development / diagnostic imaging*
  • Malformations of Cortical Development / psychology*
  • Malformations of Cortical Development / surgery
  • Neurosurgical Procedures
  • Positron-Emission Tomography
  • Radiography
  • Seizures / etiology
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome
  • Young Adult