Long-term outcome after epilepsy surgery for focal cortical dysplasia

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Object. Reports of outcomes for surgical treatment of cortical dysplasia associated with epilepsy are conflicting due to the inclusion of patients with a wide range of malformations of cortical development. The authors report their experience and the long-term outcome for a subgroup of patients with the histopathological diagnosis of focal cortical dysplasia of Taylor.

Methods. The records of 22 patients with focal cortical dysplasia of Taylor (15 with the balloon-cell type and seven with the nonballoon-cell type) were reviewed. There were 11 female and 11 male patients whose mean age was 26 ± 17.6 years (mean ± standard deviation [SD]) at surgery. The details of their epilepsy evaluation and resection were analyzed. Extent of resection was preoperatively planned using information obtained from long-term intracranial monitoring (15 patients) and/or more definitively determined by histopathologically proven clear margins during resection when feasible (12 patients). The mean duration of follow up was 6.3 ± 5.1 years (mean ± SD, range 0.5–15.6 years).

Risk factors for epilepsy were trauma (seven patients) or meningoencephalitis (one patient); 14 patients (64%) had no obvious risk factors. The mean age at seizure onset was 9.2 years and the mean duration of their epilepsy was 16.1 ± 9 years. In two patients there were no adverse findings on magnetic resonance (MR) imaging. In 15 patients (68%), the epileptogenic zone identified on long-term intracranial monitoring extended beyond the abnormality observed on MR images. Focal resection (lesion plus margins) was performed in 14 patients (64%), whereas eight (36%) underwent partial/tailored lobectomy. Two patients underwent multiple subpial transections in addition to partial lesionectomy because their lesions involved the sensorimotor cortex. In these two, functional MR imaging confirmed a normal functional anatomy despite the presence of the cortical dysplasia. Eleven (92%) of 12 patients who underwent resection guided by histopathologically proven clear margins and three (43%) of seven patients who underwent histopathologically proven subtotal resection have remained seizure free. Evidence of clear margins was significantly associated with an improved seizure outcome (p = 0.003). Postoperatively, expected deficits included nondisabling visual field defects, which occurred in three patients (14%), and transient sensorimotor deficits, which appeared in five (23%). Two patients had meningitis, which was successfully treated with antibiotics. Overall, 16 patients (73%) are either seizure free (13 patients), have rare nondisabling partial seizures (one patient), or had one seizure after their medication was changed (two patients). Thirteen patients (59%) have discontinued anticonvulsant medications or are being maintained on monotherapy. Of five patients (23%), two have had rare disabling seizures or significant reduction in their seizure frequency (three patients). One patient's seizures have remained the same.

Conclusions. Focal cortical dysplasias are a distinct subgroup of malformations of cortical development and have a favorable outcome after resection. The epileptogenic zone often extends beyond the abnormality found on neuroimaging. Resection of the epileptogenic zone guided by histopathologically proven clear margins is associated with an improved seizure outcome.

Article Information

Address reprint requests to: Aaron A. Cohen-Gadol, M.D., Department of Neurologic Surgery, Joseph 1–229, Saint Mary's Hospital, 1216 Second Street SW, Rochester, Minnesota 55905. email: cohengadol.aaron@mayo.edu.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Coronal FLAIR (left) and axial T2-weighted MR (right) images revealing a hyperintense lesion in the right anterior cingulum.

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    Left: Interictal PET study demonstrating regions of hypometabolism in a large portion of the right frontal lobe that are disproportionate to the size of the lesion on MR imaging. Center and Right: Interictal SPECT images demonstrating decreased perfusion in the bilateral orbitofrontal regions (blue and green areas).

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    Algorithm detailing our approach in the evaluation of a patient with epilepsy suspected to have a focal developmental abnormality on MR imaging.

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    Axial (left) and coronal (right) T1-weighted sequences demonstrating a right posterior parietal lesion with cortical thickening and blurring of the gray—white matter junction.

  • View in gallery

    An ictal SPECT study revealing an area of maximal hyperperfusion over the posterior right parietal region beyond the MR imaging-detected abnormality.

References

1.

Al-Rodhan NRKelly PJCascino GDet al: Surgical outcome in computer-assisted stereotactic resection of intra-axial cerebral lesions for partial epilepsy. Stereotact Funct Neurosurg 58:1721771992Al-Rodhan NR Kelly PJ Cascino GD et al: Surgical outcome in computer-assisted stereotactic resection of intra-axial cerebral lesions for partial epilepsy. Stereotact Funct Neurosurg 58:172–177 1992

2.

Aykut-Bingol CBronen RAKim JHet al: Surgical outcome in occipital lobe epilepsy: implications for pathophysiology. Ann Neurol 44:60691998Aykut-Bingol C Bronen RA Kim JH et al: Surgical outcome in occipital lobe epilepsy: implications for pathophysiology. Ann Neurol 44:60–69 1998

3.

Barkovich AJKuzniecky RI: Neuroimaging of focal malformations of cortical development. J Clin Neurophysiol 13:4814941996Barkovich AJ Kuzniecky RI: Neuroimaging of focal malformations of cortical development. J Clin Neurophysiol 13:481–494 1996

4.

Barkovich AJKuzniecky RIBollen AWet al: Focal transmantle dysplasia: a specific malformation of cortical development. Neurology 49:114811521997Barkovich AJ Kuzniecky RI Bollen AW et al: Focal transmantle dysplasia: a specific malformation of cortical development. Neurology 49:1148–1152 1997

5.

Barkovich AJKuzniecky RIJackson GDet al: Classification system for malformations of cortical development: update 2001. Neurology 57:216821782001Barkovich AJ Kuzniecky RI Jackson GD et al: Classification system for malformations of cortical development: update 2001. Neurology 57:2168–2178 2001

6.

Bass NWyllie EComair Yet al: Supplementary sensorimotor area seizures in children and adolescents. J Pediatr 126:5375441995Bass N Wyllie E Comair Y et al: Supplementary sensorimotor area seizures in children and adolescents. J Pediatr 126:537–544 1995

7.

Bastos ACComeau RMAndermann Fet al: Diagnosis of subtle focal dysplastic lesions: curvilinear reformatting from three-dimensional magnetic resonance imaging. Ann Neurol 46:88941999Bastos AC Comeau RM Andermann F et al: Diagnosis of subtle focal dysplastic lesions: curvilinear reformatting from three-dimensional magnetic resonance imaging. Ann Neurol 46:88–94 1999

8.

Battaglia GArcelli PGranata Tet al: Neuronal migration disorders and epilepsy: a morphological analysis of three surgically treated patients. Epilepsy Res 26:49581996Battaglia G Arcelli P Granata T et al: Neuronal migration disorders and epilepsy: a morphological analysis of three surgically treated patients. Epilepsy Res 26:49–58 1996

9.

Bautista RECobbs MASpencer DDet al: Prediction of surgical outcome by intracranial epileptiform abnormalities during intracranial EEG monitoring in patients with extrahippocampal seizures. Epilepsia 40:8808901999Bautista RE Cobbs MA Spencer DD et al: Prediction of surgical outcome by intracranial epileptiform abnormalities during intracranial EEG monitoring in patients with extrahippocampal seizures. Epilepsia 40:880–890 1999

10.

Bronen RAVives KPKim JHet al: Focal cortical dysplasia of Taylor, balloon cell subtype: MR differentiation from low-grade tumors. AJNR 18:114111511997Bronen RA Vives KP Kim JH et al: Focal cortical dysplasia of Taylor balloon cell subtype: MR differentiation from low-grade tumors. AJNR 18:1141–1151 1997

11.

Caraballo RCersosimo RFejerman N: A particular type of epilepsy in children with congenital hemiparesis associated with unilateral polymicrogyria. Epilepsia 40:8658711999Caraballo R Cersosimo R Fejerman N: A particular type of epilepsy in children with congenital hemiparesis associated with unilateral polymicrogyria. Epilepsia 40:865–871 1999

12.

Carmant LKramer URiviello JJet al: EEG prior to hemispherectomy: correlation with outcome and pathology. Electroencephalogr Clin Neurophysiol 94:2652701995Carmant L Kramer U Riviello JJ et al: EEG prior to hemispherectomy: correlation with outcome and pathology. Electroencephalogr Clin Neurophysiol 94:265–270 1995

13.

Chan SChin SSNordli DRet al: Prospective magnetic resonance imaging identification of focal cortical dysplasia, including the non-balloon cell subtype. Ann Neurol 44:7497571998Chan S Chin SS Nordli DR et al: Prospective magnetic resonance imaging identification of focal cortical dysplasia including the non-balloon cell subtype. Ann Neurol 44:749–757 1998

14.

Chassoux FDevaux BLandre Eet al: Stereoelectroencephalography in focal cortical dysplasia: a 3D approach to delineating the dysplastic cortex. Brain 123:173317512000Chassoux F Devaux B Landre E et al: Stereoelectroencephalography in focal cortical dysplasia: a 3D approach to delineating the dysplastic cortex. Brain 123:1733–1751 2000

15.

Chugani HShewmon DAShields WDet al: Surgery for intractable infantile spasms: neuroimaging perspectives. Epilepsia 34:7647711993Chugani H Shewmon DA Shields WD et al: Surgery for intractable infantile spasms: neuroimaging perspectives. Epilepsia 34:764–771 1993

16.

Cohen-Gadol AABritton JWCollignon FPet al: Nonlesional central lobule seizures: use of awake cortical mapping and subdural grid monitoring for resection of seizure focus. J Neurosurg 98:125512622003Cohen-Gadol AA Britton JW Collignon FP et al: Nonlesional central lobule seizures: use of awake cortical mapping and subdural grid monitoring for resection of seizure focus. J Neurosurg 98:1255–1262 2003

17.

Colombo NTassi LGalli Cet al: Focal cortical dysplasias: MR imaging, histopathologic, and clinical correlations in surgically treated patients with epilepsy. AJNR 24:7247332003Colombo N Tassi L Galli C et al: Focal cortical dysplasias: MR imaging histopathologic and clinical correlations in surgically treated patients with epilepsy. AJNR 24:724–733 2003

18.

Crino PBDuhaime ACBaltuch Get al: Differential expression of glutamate and GABA-A receptor subunit mRNA in cortical dysplasia. Neurology 56:9069132001Crino PB Duhaime AC Baltuch G et al: Differential expression of glutamate and GABA-A receptor subunit mRNA in cortical dysplasia. Neurology 56:906–913 2001

19.

Desbiens RBerkovic SFDubeau Fet al: Life-threatening focal status epilepticus due to occult cortical dysplasia. Arch Neurol 50:6957001993Desbiens R Berkovic SF Dubeau F et al: Life-threatening focal status epilepticus due to occult cortical dysplasia. Arch Neurol 50:695–700 1993

20.

Dubeau FPalmini AFish Det al: The significance of electrocorticographic findings in focal cortical dysplasia: a review of their clinical, electrophysiological and neurochemical characteristics. Electroencephalogr Clin Neurophysiol Suppl 48:77961998Dubeau F Palmini A Fish D et al: The significance of electrocorticographic findings in focal cortical dysplasia: a review of their clinical electrophysiological and neurochemical characteristics. Electroencephalogr Clin Neurophysiol Suppl 48:77–96 1998

21.

Dubeau FTampieri DLee Net al: Periventricular and sub- cortical nodular heterotopia. A study of 33 patients. Brain 118:127312871995Dubeau F Tampieri D Lee N et al: Periventricular and sub- cortical nodular heterotopia. A study of 33 patients. Brain 118:1273–1287 1995

22.

Duchowny MJayakar PHarvey ASet al: Language cortex representation: effects of developmental versus acquired pathology. Ann Neurol 40:31381996Duchowny M Jayakar P Harvey AS et al: Language cortex representation: effects of developmental versus acquired pathology. Ann Neurol 40:31–38 1996

23.

Duong TDe Rosa MJPoukens Vet al: Neuronal cytoskeletal abnormalities in human cerebral cortical dysplasia. Acta Neuropathol 87:4935031994Duong T De Rosa MJ Poukens V et al: Neuronal cytoskeletal abnormalities in human cerebral cortical dysplasia. Acta Neuropathol 87:493–503 1994

24.

Engel JVan Ness PRasmussen Tet al: Outcome with respect to epileptic seizures in Engel J Jr (ed): Surgical Treatment of the Epilepsiesed 2. New York: Raven Press1993 pp 609621Engel J Van Ness P Rasmussen T et al: Outcome with respect to epileptic seizures in Engel J Jr (ed): Surgical Treatment of the Epilepsies ed 2. New York: Raven Press 1993 pp 609–621

25.

Eriksson SMalmgren KRydenhag Bet al: Surgical treatment of epilepsy—clinical, radiological and histopathological findings in 139 children and adults. Acta Neurol Scand 99:8151999Eriksson S Malmgren K Rydenhag B et al: Surgical treatment of epilepsy—clinical radiological and histopathological findings in 139 children and adults. Acta Neurol Scand 99:8–15 1999

26.

Ferrer IPineda MTallada Met al: Abnormal local-circuit neurons in epilepsia partialis continua associated with focal cortical dysplasia. Acta Neuropathol 83:6476521992Ferrer I Pineda M Tallada M et al: Abnormal local-circuit neurons in epilepsia partialis continua associated with focal cortical dysplasia. Acta Neuropathol 83:647–652 1992

27.

Fish DRSmith SJQuesney LFet al: Surgical treatment of children with medically intractable frontal or temporal lobe epilepsy: results and highlights of 40 years' experience. Epilepsia 34:2442471993Fish DR Smith SJ Quesney LF et al: Surgical treatment of children with medically intractable frontal or temporal lobe epilepsy: results and highlights of 40 years' experience. Epilepsia 34:244–247 1993

28.

Gambardella APalmini AAndermann Fet al: Usefulness of focal rhythmic discharges on scalp EEG of patients with focal cortical dysplasia and intractable epilepsy. Electroencephalogr Clin Neurophysiol 98:2432491996Gambardella A Palmini A Andermann F et al: Usefulness of focal rhythmic discharges on scalp EEG of patients with focal cortical dysplasia and intractable epilepsy. Electroencephalogr Clin Neurophysiol 98:243–249 1996

29.

Garbelli RMunari CDe Biasi Set al: Taylor's cortical dysplasia: a confocal and ultrastructural immunohistochemical study. Brain Pathol 9:4454611999Garbelli R Munari C De Biasi S et al: Taylor's cortical dysplasia: a confocal and ultrastructural immunohistochemical study. Brain Pathol 9:445–461 1999

30.

Gleissner UJohanson KHelmstaedter Cet al: Surgical outcome in a group of low-IQ patients with focal epilepsy. Epilepsia 40:5535591999Gleissner U Johanson K Helmstaedter C et al: Surgical outcome in a group of low-IQ patients with focal epilepsy. Epilepsia 40:553–559 1999

31.

Gondo KKira HTokunaga Yet al: Reorganization of the primary somatosensory area in epilepsy associated with focal cortical dysplasia. Dev Med Child Neurol 42:8398422000Gondo K Kira H Tokunaga Y et al: Reorganization of the primary somatosensory area in epilepsy associated with focal cortical dysplasia. Dev Med Child Neurol 42:839–842 2000

32.

Guerrini RDravet CBureau Met al: Diffuse and localized dysplasias of the cerebral cortex: clinical presentation, outcome, and proposal for a morphologic MRI classification based on a study of 90 patients in Guerrini RAndermann FCanapicchi Ret al (eds): Dysplasias of Cerebral Cortex and Epilepsy. Philadelphia: Lippincott-Raven1996 pp 255269Guerrini R Dravet C Bureau M et al: Diffuse and localized dysplasias of the cerebral cortex: clinical presentation outcome and proposal for a morphologic MRI classification based on a study of 90 patients in Guerrini R Andermann F Canapicchi R et al (eds): Dysplasias of Cerebral Cortex and Epilepsy. Philadelphia: Lippincott-Raven 1996 pp 255–269

33.

Hashizume KKiriyama KKunimoto Met al: Correlation of EEG, neuroimaging and histopathology in an epilepsy patient with diffuse cortical dysplasia. Childs Nerv Syst 16:75792000Hashizume K Kiriyama K Kunimoto M et al: Correlation of EEG neuroimaging and histopathology in an epilepsy patient with diffuse cortical dysplasia. Childs Nerv Syst 16:75–79 2000

34.

Hirabayashi SBinnie CDJanota Iet al: Surgical treatment of epilepsy due to cortical dysplasia: clinical and EEG findings. J Neurol Neurosurg Psychiatry 56:7657701993Hirabayashi S Binnie CD Janota I et al: Surgical treatment of epilepsy due to cortical dysplasia: clinical and EEG findings. J Neurol Neurosurg Psychiatry 56:765–770 1993

35.

Hong SCKang KSSeo DWet al: Surgical treatment of intractable epilepsy accompanying cortical dysplasia. J Neurosurg 93:7667732000Hong SC Kang KS Seo DW et al: Surgical treatment of intractable epilepsy accompanying cortical dysplasia. J Neurosurg 93:766–773 2000

36.

Hopkins IJKlug GL: Temporal lobectomy for the treatment of intractable complex partial seizures of temporal lobe origin in early childhood. Dev Med Child Neurol 33:26311991Hopkins IJ Klug GL: Temporal lobectomy for the treatment of intractable complex partial seizures of temporal lobe origin in early childhood. Dev Med Child Neurol 33:26–31 1991

37.

Jambaque IMottron LPonsot Get al: Autism and visual agnosia in a child with right occipital lobectomy. J Neurol Neurosurg Psychiatry 65:5555601998Jambaque I Mottron L Ponsot G et al: Autism and visual agnosia in a child with right occipital lobectomy. J Neurol Neurosurg Psychiatry 65:555–560 1998

38.

Kameyama SFukuda MTomikawa Met al: Surgical strategy and outcomes for epileptic patients with focal cortical dysplasia or dysembryoplastic neuroepithelial tumor. Epilepsia 42 (Suppl 6):37412001Kameyama S Fukuda M Tomikawa M et al: Surgical strategy and outcomes for epileptic patients with focal cortical dysplasia or dysembryoplastic neuroepithelial tumor. Epilepsia 42 (Suppl 6):37–41 2001

39.

Keene DLJimenez CCVentureyra E: Cortical microdysplasia and surgical outcome in refractory epilepsy of childhood. Pediatr Neurosurg 29:69721998Keene DL Jimenez CC Ventureyra E: Cortical microdysplasia and surgical outcome in refractory epilepsy of childhood. Pediatr Neurosurg 29:69–72 1998

40.

Khanna SChugani HTMessa Cet al: Corpus callosum agenesis and epilepsy: PET findings. Pediatr Neurol 10:2212271994Khanna S Chugani HT Messa C et al: Corpus callosum agenesis and epilepsy: PET findings. Pediatr Neurol 10:221–227 1994

41.

Kilpatrick CCook MKaye Aet al: Non-invasive investigations successfully select patients for temporal lobe surgery. J Neurol Neurosurg Psychiatry 63:3273331997Kilpatrick C Cook M Kaye A et al: Non-invasive investigations successfully select patients for temporal lobe surgery. J Neurol Neurosurg Psychiatry 63:327–333 1997

42.

Kim JH: Pathology of epilepsy. Exp Mol Pathol 70:3453672001Kim JH: Pathology of epilepsy. Exp Mol Pathol 70:345–367 2001

43.

Kuzniecky RI: Magnetic resonance imaging in developmental disorders of the cerebral cortex. Epilepsia 35 (Suppl 6):S44S561994Kuzniecky RI: Magnetic resonance imaging in developmental disorders of the cerebral cortex. Epilepsia 35 (Suppl 6):S44–S56 1994

44.

Kuzniecky RI: Neuroimaging in pediatric epilepsy. Epilepsia 37 (Suppl 1):S10S211996Kuzniecky RI: Neuroimaging in pediatric epilepsy. Epilepsia 37 (Suppl 1):S10–S21 1996

45.

Kuzniecky RBerkovic SAndermann Fet al: Focal cortical myoclonus and rolandic cortical dysplasia: clarification by magnetic resonance imaging. Ann Neurol 23:3173251988Kuzniecky R Berkovic S Andermann F et al: Focal cortical myoclonus and rolandic cortical dysplasia: clarification by magnetic resonance imaging. Ann Neurol 23:317–325 1988

46.

Kuzniecky RGarcia JHFaught Eet al: Cortical dysplasia in temporal lobe epilepsy: magnetic resonance imaging correlations. Ann Neurol 29:2932981991Kuzniecky R Garcia JH Faught E et al: Cortical dysplasia in temporal lobe epilepsy: magnetic resonance imaging correlations. Ann Neurol 29:293–298 1991

47.

Kuzniecky RGilliam FMorawetz Ret al: Occipital lobe developmental malformations and epilepsy: clinical spectrum, treatment, and outcome. Epilepsia 38:1751811997Kuzniecky R Gilliam F Morawetz R et al: Occipital lobe developmental malformations and epilepsy: clinical spectrum treatment and outcome. Epilepsia 38:175–181 1997

48.

Kuzniecky RHetherington HPan Jet al: Proton spectroscopic imaging at 4.1 tesla in patients with malformations of cortical development and epilepsy. Neurology 48:101810241997Kuzniecky R Hetherington H Pan J et al: Proton spectroscopic imaging at 4.1 tesla in patients with malformations of cortical development and epilepsy. Neurology 48:1018–1024 1997

49.

Kuzniecky RMorawetz RFaught Eet al: Frontal and central lobe focal dysplasia: clinical, EEG and imaging features. Dev Med Child Neurol 37:1591661995Kuzniecky R Morawetz R Faught E et al: Frontal and central lobe focal dysplasia: clinical EEG and imaging features. Dev Med Child Neurol 37:159–166 1995

50.

Kuzniecky RMountz JMWheatley Get al: Ictal single-photon emission computed tomography demonstrates localized epileptogenesis in cortical dysplasia. Ann Neurol 34:6276311993Kuzniecky R Mountz JM Wheatley G et al: Ictal single-photon emission computed tomography demonstrates localized epileptogenesis in cortical dysplasia. Ann Neurol 34:627–631 1993

51.

Kuzniecky RMurro AKing Det al: Magnetic resonance imaging in childhood intractable partial epilepsies: pathologic correlations. Neurology 43:6816871993Kuzniecky R Murro A King D et al: Magnetic resonance imaging in childhood intractable partial epilepsies: pathologic correlations. Neurology 43:681–687 1993

52.

Kuzniecky RPowers R: Epilepsia partialis continua due to cortical dysplasia. J Child Neurol 8:3863881993Kuzniecky R Powers R: Epilepsia partialis continua due to cortical dysplasia. J Child Neurol 8:386–388 1993

53.

Landy HJRamsay REAjmone-Marsan Cet al: Temporal lobectomy for seizures associated with unilateral schizencephaly. Surg Neurol 37:4774811992Landy HJ Ramsay RE Ajmone-Marsan C et al: Temporal lobectomy for seizures associated with unilateral schizencephaly. Surg Neurol 37:477–481 1992

54.

Laskowitz DTSperling MRFrench JAet al: The syndrome of frontal lobe epilepsy: characteristics and surgical management. Neurology 45:7807871995Laskowitz DT Sperling MR French JA et al: The syndrome of frontal lobe epilepsy: characteristics and surgical management. Neurology 45:780–787 1995

55.

Leblanc RTampieri DRobitaille Yet al: Surgical treatment of intractable epilepsy associated with schizencephaly. Neurosurgery 29:4214291991Leblanc R Tampieri D Robitaille Y et al: Surgical treatment of intractable epilepsy associated with schizencephaly. Neurosurgery 29:421–429 1991

56.

Lee NRadtke RGray Let al: Neuronal migration disorders: positron emission tomography correlations. Ann Neurol 35:2902971994Lee N Radtke R Gray L et al: Neuronal migration disorders: positron emission tomography correlations. Ann Neurol 35:290–297 1994

57.

Li LMCendes FAndermann Fet al: Surgical outcome in patients with epilepsy and dual pathology. Brain 122:7998051999Li LM Cendes F Andermann F et al: Surgical outcome in patients with epilepsy and dual pathology. Brain 122:799–805 1999

58.

Li LMDubeau FAndermann Fet al: Periventricular nodular heterotopia and intractable temporal lobe epilepsy: poor outcome after temporal lobe resection. Ann Neurol 41:6626681997Li LM Dubeau F Andermann F et al: Periventricular nodular heterotopia and intractable temporal lobe epilepsy: poor outcome after temporal lobe resection. Ann Neurol 41:662–668 1997

59.

Lindsay JOunsted CRichards P: Hemispherectomy for childhood epilepsy: a 36-year study. Dev Med Child Neurol 29:5926001987Lindsay J Ounsted C Richards P: Hemispherectomy for childhood epilepsy: a 36-year study. Dev Med Child Neurol 29:592–600 1987

60.

Lombroso CT: Can early postnatal closed head injury induce cortical dysplasia. Epilepsia 41:2452532000Lombroso CT: Can early postnatal closed head injury induce cortical dysplasia. Epilepsia 41:245–253 2000

61.

Maegaki YYamamoto TTakeshita K: Plasticity of central motor and sensory pathways in a case of unilateral extensive cortical dysplasia: investigation of magnetic resonance imaging, transcranial magnetic stimulation, and short-latency somatosensory evoked potentials. Neurology 45:225522611995Maegaki Y Yamamoto T Takeshita K: Plasticity of central motor and sensory pathways in a case of unilateral extensive cortical dysplasia: investigation of magnetic resonance imaging transcranial magnetic stimulation and short-latency somatosensory evoked potentials. Neurology 45:2255–2261 1995

62.

Maehara TShimizu HNakayama Het al: Surgical treatment of epilepsy from schizencephaly with fused lips. Surg Neurol 48:5075101997Maehara T Shimizu H Nakayama H et al: Surgical treatment of epilepsy from schizencephaly with fused lips. Surg Neurol 48:507–510 1997

63.

Marco PSola RGPulido Pet al: Inhibitory neurons in the human epileptogenic temporal neocortex. An immunocytochemical study. Brain 119:132713471996Marco P Sola RG Pulido P et al: Inhibitory neurons in the human epileptogenic temporal neocortex. An immunocytochemical study. Brain 119:1327–1347 1996

64.

Marusic PNajm IMYing Zet al: Focal cortical dysplasias in eloquent cortex: functional characteristics and correlation with MRI and histopathologic changes. Epilepsia 43:27322002Marusic P Najm IM Ying Z et al: Focal cortical dysplasias in eloquent cortex: functional characteristics and correlation with MRI and histopathologic changes. Epilepsia 43:27–32 2002

65.

Mathern GWCepeda CHurst RSet al: Neurons recorded from pediatric epilepsy surgery patients with cortical dysplasia. Epilepsia 41 (Suppl 6):S162S1672000Mathern GW Cepeda C Hurst RS et al: Neurons recorded from pediatric epilepsy surgery patients with cortical dysplasia. Epilepsia 41 (Suppl 6):S162–S167 2000

66.

Mischel PSNguyen LPVinters HV: Cerebral cortical dysplasia associated with pediatric epilepsy. Review of neuropathologic features and proposal for a grading system. J Neuropathol Exp Neurol 54:1371531995Mischel PS Nguyen LP Vinters HV: Cerebral cortical dysplasia associated with pediatric epilepsy. Review of neuropathologic features and proposal for a grading system. J Neuropathol Exp Neurol 54:137–153 1995

67.

Montes JLRosenblatt BFarmer JPet al: Lesionectomy of MRI detected lesions in children with epilepsy. Pediatr Neurosurg 22:1671731995Montes JL Rosenblatt B Farmer JP et al: Lesionectomy of MRI detected lesions in children with epilepsy. Pediatr Neurosurg 22:167–173 1995

68.

Morioka TNishio SIshibashi Het al: Intrinsic epileptogenicity of focal cortical dysplasia as revealed by magnetoencephalography and electrocorticography. Epilepsy Res 33:1771871999Morioka T Nishio S Ishibashi H et al: Intrinsic epileptogenicity of focal cortical dysplasia as revealed by magnetoencephalography and electrocorticography. Epilepsy Res 33:177–187 1999

69.

Morris RGFeigenbaum JDBinnie CDet al: Plasticity of right parietal lobe functioning in focal cortical dysplasia. Adv Neurol 81:3633701999Morris RG Feigenbaum JD Binnie CD et al: Plasticity of right parietal lobe functioning in focal cortical dysplasia. Adv Neurol 81:363–370 1999

70.

O'Brien TJSo ELMullan BPet al: Subtraction ictal SPECT coregistered to MRI improves clinical usefulness of SPECT in localizing the surgical seizure focus. Neurology 50:4454541998O'Brien TJ So EL Mullan BP et al: Subtraction ictal SPECT coregistered to MRI improves clinical usefulness of SPECT in localizing the surgical seizure focus. Neurology 50:445–454 1998

71.

Olivier AAndermann FPalmini Aet al: Surgical treatment of the cortical dysplasias in Guerrini RAndermann FCanapicchi Ret al (eds): Dysplasias of Cerebral Cortex and Epilepsy. Philadelphia: Lippincott-Raven1996 pp 351366Olivier A Andermann F Palmini A et al: Surgical treatment of the cortical dysplasias in Guerrini R Andermann F Canapicchi R et al (eds): Dysplasias of Cerebral Cortex and Epilepsy. Philadelphia: Lippincott-Raven 1996 pp 351–366

72.

Palmini AAndermann FOlivier Aet al: Focal neuronal migration disorders and intractable partial epilepsy: a study of 30 patients. Ann Neurol 30:7417491991Palmini A Andermann F Olivier A et al: Focal neuronal migration disorders and intractable partial epilepsy: a study of 30 patients. Ann Neurol 30:741–749 1991

73.

Palmini AAndermann FOlivier Aet al: Focal neuronal migration disorders and intractable partial epilepsy: results of surgical treatment. Ann Neurol 30:7507571991Palmini A Andermann F Olivier A et al: Focal neuronal migration disorders and intractable partial epilepsy: results of surgical treatment. Ann Neurol 30:750–757 1991

74.

Palmini AGambardella AAndermann Fet al: Intrinsic epileptogenicity of human dysplastic cortex as suggested by corticography and surgical results. Ann Neurol 37:4764871995Palmini A Gambardella A Andermann F et al: Intrinsic epileptogenicity of human dysplastic cortex as suggested by corticography and surgical results. Ann Neurol 37:476–487 1995

75.

Palmini AGambardella AAndermann Fet al: Operative strategies for patients with cortical dysplastic lesions and intractable epilepsy. Epilepsia 35 (Suppl 6):S57S711994Palmini A Gambardella A Andermann F et al: Operative strategies for patients with cortical dysplastic lesions and intractable epilepsy. Epilepsia 35 (Suppl 6):S57–S71 1994

76.

Pedespan JMLoiseau HVital Aet al: Surgical treatment of an early epileptic encephalopathy with suppression-bursts and focal cortical dysplasia. Epilepsia 36:37401995Pedespan JM Loiseau H Vital A et al: Surgical treatment of an early epileptic encephalopathy with suppression-bursts and focal cortical dysplasia. Epilepsia 36:37–40 1995

77.

Pinard JMDelalande ODulac O: Hemispherotomy and callosotomy for cortical dysplasia in children: technique and postoperative outcome in Guerrini RAndermann FCanapicchi Ret al (eds): Dysplasias of Cerebral Cortex and Epilepsy. Philadelphia: Lippincott-Raven1996 pp 375381Pinard JM Delalande O Dulac O: Hemispherotomy and callosotomy for cortical dysplasia in children: technique and postoperative outcome in Guerrini R Andermann F Canapicchi R et al (eds): Dysplasias of Cerebral Cortex and Epilepsy. Philadelphia: Lippincott-Raven 1996 pp 375–381

78.

Raymond AAFish DRSisodiya SMet al: Abnormalities of gyration, heterotopias, tuberous sclerosis, focal cortical dysplasia, microdysgenesis, dysembryoplastic neuroepithelial tumor and dysgenesis of the archicortex in epilepsy. Clinical, EEG and neuroimaging features in 100 adult patients. Brain 118:6296601995Raymond AA Fish DR Sisodiya SM et al: Abnormalities of gyration heterotopias tuberous sclerosis focal cortical dysplasia microdysgenesis dysembryoplastic neuroepithelial tumor and dysgenesis of the archicortex in epilepsy. Clinical EEG and neuroimaging features in 100 adult patients. Brain 118:629–660 1995

79.

Redecker CLutzenburg MGressens Pet al: Excitability changes and glucose metabolism in experimentally induced focal cortical dysplasias. Cereb Cortex 8:6236341998Redecker C Lutzenburg M Gressens P et al: Excitability changes and glucose metabolism in experimentally induced focal cortical dysplasias. Cereb Cortex 8:623–634 1998

80.

Rintahaka PJChugani HTMessa Cet al: Hemimegalencephaly: evaluation with positron emission tomography. Pediatr Neurol 9:21281993Rintahaka PJ Chugani HT Messa C et al: Hemimegalencephaly: evaluation with positron emission tomography. Pediatr Neurol 9:21–28 1993

81.

Rosenow FLuders HODinner DSet al: Histopathological correlates of epileptogenicity as expressed by electrocorticographic spiking and seizure frequency. Epilepsia 39:8508561998Rosenow F Luders HO Dinner DS et al: Histopathological correlates of epileptogenicity as expressed by electrocorticographic spiking and seizure frequency. Epilepsia 39:850–856 1998

82.

Ryvlin PBouvard SLe Bars Det al: Clinical utility of flumazenil-PET versus [18F]fluorodeoxyplucose-PET and MRI in refractory partial epilepsy. A prospective study in 100 patients. Brain 121:206720811998Ryvlin P Bouvard S Le Bars D et al: Clinical utility of flumazenil-PET versus [18F]fluorodeoxyplucose-PET and MRI in refractory partial epilepsy. A prospective study in 100 patients. Brain 121:2067–2081 1998

83.

Saint Martin CAdamsbaum CRobain Oet al: An unusual presentation of focal cortical dysplasia. AJNR 16 (Suppl 4):8408421995Saint Martin C Adamsbaum C Robain O et al: An unusual presentation of focal cortical dysplasia. AJNR 16 (Suppl 4):840–842 1995

84.

Salanova VAndermann FOlivier Aet al: Occipital lobe epilepsy: electroclinical manifestations, electrocorticography, cortical stimulation and outcome in 42 patients treated between 1930 and 1991. Surgery of occipital lobe epilepsy. Brain 115:165516801992Salanova V Andermann F Olivier A et al: Occipital lobe epilepsy: electroclinical manifestations electrocorticography cortical stimulation and outcome in 42 patients treated between 1930 and 1991. Surgery of occipital lobe epilepsy. Brain 115:1655–1680 1992

85.

Salanova VAndermann FRassmusen Tet al: Parietal lobe epilepsy. Clinical manifestations and outcome in 82 patients treated surgically between 1929 and 1988. Brain 118:6076271995Salanova V Andermann F Rassmusen T et al: Parietal lobe epilepsy. Clinical manifestations and outcome in 82 patients treated surgically between 1929 and 1988. Brain 118:607–627 1995

86.

Sandok EKCascino GD: Surgical treatment for perirolandic lesional epilepsy. Epilepsia 39 (Suppl 4):S42S481998Sandok EK Cascino GD: Surgical treatment for perirolandic lesional epilepsy. Epilepsia 39 (Suppl 4):S42–S48 1998

87.

Sawhney IMRobertson IJPolkey CEet al: Multiple subpial transection: a review of 21 cases. J Neurol Neurosurg Psychiatry 58:3443491995Sawhney IM Robertson IJ Polkey CE et al: Multiple subpial transection: a review of 21 cases. J Neuyrol Neurosurg Psychiatry 58:344–349 1995

88.

Semah FPicot MCAdam Cet al: Is the underlying cause of epilepsy a major prognostic factor for recurrence? Neurology 51:125612621998Semah F Picot MC Adam C et al: Is the underlying cause of epilepsy a major prognostic factor for recurrence? Neurology 51:1256–1262 1998

89.

Shaver EGHarvey ASMorrison Get al: Results and complications after reoperation for failed epilepsy surgery in children. Pediatr Neurosurg 27:1942021997Shaver EG Harvey AS Morrison G et al: Results and complications after reoperation for failed epilepsy surgery in children. Pediatr Neurosurg 27:194–202 1997

90.

Silbergeld DLMiller JW: Resective surgery for medically intractable epilepsy associated schizencephaly. J Neurosurg 80:8208251994Silbergeld DL Miller JW: Resective surgery for medically intractable epilepsy associated schizencephaly. J Neurosurg 80:820–825 1994

91.

Sisodiya SM: Surgery for malformations of cortical development causing epilepsy. Brain 123:107510912000Sisodiya SM: Surgery for malformations of cortical development causing epilepsy. Brain 123:1075–1091 2000

92.

So NK: Mesial frontal epilepsy. Epilepsia 39 (Suppl 4):S49S611998So NK: Mesial frontal epilepsy. Epilepsia 39 (Suppl 4):S49–S61 1998

93.

Spencer DD: Classifying the epilepsies by substrate. Clin Neurosci 2:1041091994Spencer DD: Classifying the epilepsies by substrate. Clin Neurosci 2:104–109 1994

94.

Spreafico RBattaglia GArcelli Pet al: Cortical dysplasia: an immunocytochemical study of three patients. Neurology 50:27361998Spreafico R Battaglia G Arcelli P et al: Cortical dysplasia: an immunocytochemical study of three patients. Neurology 50:27–36 1998

95.

Spreafico RPasquier BMinotti Let al: Immunocytochemical investigation on dysplastic human tissue from epileptic patients. Epilepsy Res 32:34481998Spreafico R Pasquier B Minotti L et al: Immunocytochemical investigation on dysplastic human tissue from epileptic patients. Epilepsy Res 32:34–48 1998

96.

Spreafico RTassi LColombo Net al: Inhibitory circuits in human dysplastic tissue. Epilepsia 41 (Suppl 6):S168S1732000Spreafico R Tassi L Colombo N et al: Inhibitory circuits in human dysplastic tissue. Epilepsia 41 (Suppl 6):S168–S173 2000

97.

Sugimoto TOtsubo HHwang PAet al: Outcome of epilepsy surgery in the first three years of life. Epilepsia 40:5605651999Sugimoto T Otsubo H Hwang PA et al: Outcome of epilepsy surgery in the first three years of life. Epilepsia 40:560–565 1999

98.

Swartz BEDelgado-Escueta AVWalsh GOet al: Surgical outcomes in pure frontal lobe epilepsy and foci that mimic them. Epilepsy Res 29:971081998Swartz BE Delgado-Escueta AV Walsh GO et al: Surgical outcomes in pure frontal lobe epilepsy and foci that mimic them. Epilepsy Res 29:97–108 1998

99.

Szabo CAWyllie EDolske Met al: Epilepsy surgery in children with pervasive developmental disorder. Pediatr Neurol 20:3493531999Szabo CA Wyllie E Dolske M et al: Epilepsy surgery in children with pervasive developmental disorder. Pediatr Neurol 20:349–353 1999

100.

Taha JMCrone KRBerger TS: The role of hemispherectomy in the treatment of holohemispheric hemimegaloencephaly. J Neurosurg 81:37421994Taha JM Crone KR Berger TS: The role of hemispherectomy in the treatment of holohemispheric hemimegaloencephaly. J Neurosurg 81:37–42 1994

101.

Tassi LColombo NGarbelli Ret al: Focal cortical dysplasia: neuropathological subtypes, EEG, neuroimaging and surgical outcome. Brain 125:171917322002Tassi L Colombo N Garbelli R et al: Focal cortical dysplasia: neuropathological subtypes EEG neuroimaging and surgical outcome. Brain 125:1719–1732 2002

102.

Tassi LPasquier BMinotti Let al: Cortical dysplasia: electroclinical, imaging, and neuropathologic study of 13 patients. Epilepsia 42:111211232001Tassi L Pasquier B Minotti L et al: Cortical dysplasia: electroclinical imaging and neuropathologic study of 13 patients. Epilepsia 42:1112–1123 2001

103.

Taylor DCFalconer MABruton CJet al: Focal dysplasia of the cerebral cortex in epilepsy. J Neurol Neurosurg Psychiatry 34:3693871971Taylor DC Falconer MA Bruton CJ et al: Focal dysplasia of the cerebral cortex in epilepsy. J Neurol Neurosurg Psychiatry 34:369–387 1971

104.

Thom MMoran NFPlant GTet al: Cortical dysplasia with angiodysgenesis and chronic inflammation in multifocal partial epilepsy. Neurology 52:6546571999Thom M Moran NF Plant GT et al: Cortical dysplasia with angiodysgenesis and chronic inflammation in multifocal partial epilepsy. Neurology 52:654–657 1999

105.

Tran TASpencer SSJavidan Met al: Significance of spikes recorded on intraoperative electrocorticography in patients with brain tumor and epilepsy. Epilepsia 38:113211391997Tran TA Spencer SS Javidan M et al: Significance of spikes recorded on intraoperative electrocorticography in patients with brain tumor and epilepsy. Epilepsia 38:1132–1139 1997

106.

Urbach HScheffler BHeinrichsmeier Tet al: Focal cortical dysplasia of Taylor's balloon cell type: a clinicopathological entity with characteristic neuroimaging and histopathological features, and favorable postsurgical outcome. Epilepsia 43:33402002Urbach H Scheffler B Heinrichsmeier T et al: Focal cortical dysplasia of Taylor's balloon cell type: a clinicopathological entity with characteristic neuroimaging and histopathological features and favorable postsurgical outcome. Epilepsia 43:33–40 2002

107.

Verity CMStrauss EHMoyes PDet al: Long-term follow-up after cerebral hemispherectomy. neurophysiologic, radiologic, and psychological findings. Neurology 32:6296391982Verity CM Strauss EH Moyes PD et al: Long-term follow-up after cerebral hemispherectomy. neurophysiologic radiologic and psychological findings. Neurology 32:629–639 1982

108.

Wyllie EComair YRuggieri Pet al: Epilepsy surgery in the setting of periventricular leukomalacia and focal cortical dysplasia. Neurology 46:8398411996Wyllie E Comair Y Ruggieri P et al: Epilepsy surgery in the setting of periventricular leukomalacia and focal cortical dysplasia. Neurology 46:839–841 1996

109.

Wyllie EComair YGKotagal Pet al: Epilepsy surgery in infants. Epilepsia 37:6256371996Wyllie E Comair YG Kotagal P et al: Epilepsy surgery in infants. Epilepsia 37:625–637 1996

110.

Wyllie EComair YGKotagal Pet al: Seizure outcome after epilepsy surgery in children and adolescents. Ann Neurol 44:7407481998Wyllie E Comair YG Kotagal P et al: Seizure outcome after epilepsy surgery in children and adolescents. Ann Neurol 44:740–748 1998

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