Focal cortical dysplasia: a review of pathological features, genetics, and surgical outcome

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Focal cortical dysplasia (FCD) is found in approximately one-half of patients with medically refractory epilepsy. These lesions may involve only mild disorganization of the cortex, but they may also contain abnormal neuronal elements such as balloon cells. Advances in neuroimaging have allowed better identification of these lesions, and thus more patients have become surgical candidates. Molecular biology techniques have been used to explore the genetics and pathophysiological characteristics of FCD. Data from surgical series have shown that surgery often results in significant reduction or cessation of seizures, especially if the entire lesion is resected.

Abbreviations used in this paper:AMPA = α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid; EEG = electroencephalography; FCD = focal cortical dysplasia; GABA = γ-aminobutyric acid; GluR = glutamate receptor; MR = magnetic resonance; NMDA = N-methyl-d-aspartate; NR = NMDA receptor.

Focal cortical dysplasia (FCD) is found in approximately one-half of patients with medically refractory epilepsy. These lesions may involve only mild disorganization of the cortex, but they may also contain abnormal neuronal elements such as balloon cells. Advances in neuroimaging have allowed better identification of these lesions, and thus more patients have become surgical candidates. Molecular biology techniques have been used to explore the genetics and pathophysiological characteristics of FCD. Data from surgical series have shown that surgery often results in significant reduction or cessation of seizures, especially if the entire lesion is resected.

Abbreviations used in this paper:AMPA = α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid; EEG = electroencephalography; FCD = focal cortical dysplasia; GABA = γ-aminobutyric acid; GluR = glutamate receptor; MR = magnetic resonance; NMDA = N-methyl-d-aspartate; NR = NMDA receptor.

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Contributor Notes

Address reprint requests to: Nicholas M. Barbaro, M.D., Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, California 94130. email: barbaron@neurosurg.ucsf.edu.

© AANS, except where prohibited by US copyright law.

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