Abstracts

Rationale: To evaluate the diagnostic status of focal cortical dysplasia (FCD) in developing area and explore the underlying causes and possible methods to fill the diagnostic gap.Methods: A total of 260 consecutive surgical cases of intractable epilepsy from Jan 2012 to Dec 2013 were pathologically re-examined. FCD was diagnosed according to the International League Against Epilepsy 2011 classification. A questionnaire investigation was carried out to explore the underlying causes for diagnostic gap and a short-term training program was performed to assess the diagnosis improvement.Results: Of the 71 FCD cases identified in our study, 59 (83.1%) were misdiagnosed at the initial examination. The overall usage of special stains in pathologic diagnosis for intractable epilepsy surgery specimen was 32.7% whilst the remaining had only H&E staining. Sixty percent of participant pathologists lack the sufficient knowledge about the new classification of FCD and suggested diagnostic procedure. Nearly 90% had never or occasionally attained training courses focused on FCD. The diagnostic sensitivity for FCD subtypes were significantly improved by two to six folds after a short term training (p=0.043, 0.034 and 0.043, FCD I, II and III respectively) while the specificity remained steady.Conclusions: It is essential to provide continuing education and focused training to improve diagnostic skills on FCD. Multicenter consulting and discussion were needed when dealing with FCD diagnosis gap. There is clearly a fulfilling role here for interested neuropathologists from the developed area to work with interested pathologists and doctors in the developing areas.