Abstracts

Rationale: Focal cortical dysplasia (FCD) is a common finding in patients with intractable epilepsy. The location of the dysplasia is relevant for surgery. Proximity of the FCD to motor strip has implications for surgical planning and anticipated post-operative deficit. Methods: We reviewed the records of patients who underwent surgical resection of focal cortical dysplasia over the past four years. The location of each area of dysplasia was noted to either be in the proximity of the motor strip or distant to the motor strip. A comparison was made between two groups of patients—one group two years of age or younger, the second group over two years of age. Results: In total, 18 patients were reviewed ranging in age at the time of surgery from 2 months to 21 years. 6 patients were 2 years or younger and 12 were over the age of 2 years. Within the younger group, 6 of the 6 (100%) had lesions either within or in close proximity to the motor strip and 5 of the 6 (83%) had contralateral focal weakness or hypotonia prior to surgery. 3 of the 6 (50%) had greater than 100 seizures per week prior to surgery, and 5 of the 6 (83%) had greater than 20 seizures per week. All 6 of the younger patients achieved Engel class I seizure control after surgery with either improved (3 of 6) or stable motor deficits compared to their pre-operative exam. Within the older group, 2 of the 12 (17%) had lesions in proximity to the motor strip. While over the age of two, both of these patients were young (age 3 and 5 years). Only 1 of those 2 (8%) presented with a motor deficit. 2 of the 12 patients (17%) had greater that 100 seizures per week prior to surgery and 4 of the 12 patients (33%) had greater than 20 seizures per week. Conclusions: In this small group of patients, there is a pattern in the location of focal cortical dysplasia. The younger patients all had FCD either in or near their motor strip. Coupled with this was a tendency to have a motor deficit prior to surgery. Their seizure disorders were more severe prompting early surgical intervention. These young patients had good outcomes from epilepsy surgery, both in terms of seizure control and motor function.