Authors :
Presenting Author: Marlene Huamani Mendoza, MD – Instituto Nacional de Ciencias Neurologicas
Alexis Mateo Pecho, MD – Neurologist, Epilepsy, Instituto Nacional de Ciencias Neurologicas; liza Nuñez del Prado, MD – NEUROLOGIST EPILEPTOLOGIST, EPILEPSY, INSTITUTO NACIONAL DE CIENCIAS NEUROLOGICAS; Denisse Chacón, MD – Neurologist Epileptologist, Epilepsy, Instituto Nacional de Ciencias Neurologicas; Sofia Sanchez Boluarte, MD – Neurologist, Epilepsy, Instituto Nacional de Ciencias Neurologicas; Walter De La Cruz, MD – Neurologist Epileptologist, Chief of Epilepsy, Instituto Nacional de Ciencias Neurologicas
Rationale:
Focal Cortical Dysplasia (FCD) is a common cause of medically intractable epilepsy. Epilepsy surgery has become an increasingly successfully treatment option. We aimed to determine the clinical, electroencephalographic, neuroimaging and histopathological characteristics of patients with focal epilepsy due FCD and to assess predictive factors of epilepsy surgery.
Methods:
We retrospectively analyzed the data of 10 adult patients undergoing epilepsy surgery for histologically proven FCD in a specialized neurological center in Lima from 2012 to 2022 and were followed for at least one year after surgery. Patients were analyzed regarding the longitudinal course of seizure control, effects of FCD type, localization, magnetic resonance imaging (MRI), ictal and interictal video EEG, timing of surgery, and postoperative antiepileptic treatment.
Results:
The mean age at epilepsy onset was six years (0-17 years), and mean age at epilepsy surgery was 26 years (19-38 years). The main electroencephalographic findings corresponded to RED type 2 (Quasicontinous 4-to 5Hz rhythmic sharp wave activity >80% of the record) in 7 cases and 2 cases with FBREA (Frequent Rhythmic Outburst Epileptiform Activity). The main imaging findings were cortical thickening, transmantal sign, and blurring between the gray matter and white matter. FCD type IIa ILAE task force classification was the frequent histopathological finding.The number of drugs used prior to surgery were three (with ranges from two to five), with Lamotrigine and Clobazam being the main ones used.
After one year, Engel class I outcome was achieved in 70% of patients and decrease in seizures greater than 75% over the following years. Complete resection of the assumed epileptogenic area, and unilobar localization were positive prognostic indicators of long- term seizure freedom.
Conclusions:
The findings correspond to the first study of epilepsy due to Focal Cortical Dysplasia in our country. The electroencephalographic characteristics were like other studies, however, the surgery times were very long. Postoperative long-term seizure outcome was favorable in patients with FCD and remained stable in 70% of patients after the first postoperative year.
Funding: None