Abstracts

Rationale: Intractable epilepsy is the failure of 2 antiepileptics (AED) to control seizures when using the appropriate AED and doses for seizure type. Polymicrogyria (PMG), a variant of cortical malformation, is a common cause of intractable epilepsy. Most cases of PMG were diagnosed either radiologically or via pathology. Surgical treatment in PMG is limited, given the extensive nature of the disease. Our aim in the study is to evaluate the effect of epilepsy surgery in seizure control in PMG patients and assess the genotype-and-phenotype correlation if applicable.

Methods: Retrospective data collection from medical and radiology records of children aged 0 to 14 years diagnosed with intractable epilepsy secondary to PMG based on radiological findings, who underwent epilepsy surgery in KFSHRC between January 2005 and May 2021.

Results: A total of 18 patients with average seizure onset between 3 days and 36 months underwent epilepsy surgery (either single or multiple surgeries). Ten patients underwent functional hemispherectomy, six underwent VNS, one underwent frontal disconnection, one underwent subtotal resection, and two underwent corpus callosotomy. Seven patients had seizure freedom, mainly in the functional hemispherectomy group. In contrast, Six patients had more than 50% to 75% reduction in their seizure frequency. However, five patients had no change or worsening mainly in seizure seen in the VNS group.

Conclusions: The presented study emphasises the importance of considering epilepsy surgery as a method for seizure control in PMG patients despite the extensive nature of the disease. Various surgical opinions are available, with functional hemispherectomy and disconnection surgery showing the best outcome.

Funding: None