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Surgically Treated Intractable Child Epilepsy with Focal Cortical Dysplasia : Clinical and Electroencephalographic Findings

Journal of the Korean Pediatric Society 2001;44(5):552-561.
Published online May 15, 2001.
Surgically Treated Intractable Child Epilepsy with Focal Cortical Dysplasia : Clinical and Electroencephalographic Findings
So Hee Chung1, Ho Young Lee1, Mun Hyang Lee1, Hye Kyung Yoon2, Bo Kyung Kim2, Seung Chyul Hong3
1Departments of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
2Departments of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
3Departments of Neurosurgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
수술 치료를 받은 대뇌 국소 피질이형성증을 동반한 난치성 소아간질의 뇌파 및 임상소견
정소희1, 이호영1, 이문향1, 윤혜경2, 김보경2, 홍승철3
1성균관대학교 의과대학 삼성서울병원 소아과
2성균관대학교 의과대학 삼성서울병원 영상의학과
3성균관대학교 의과대학 삼성서울병원 신경외과
Correspondence: 
Mun Hyang Lee, Email: mhlee@smc.samsung.co.kr
Abstract
Purpose
: Widespread use of MRI now gives us increased insights into the different expressions of cortical malformations. We carried out this study to characterize the clinical and EEG features of focal cortical dysplasia(FCD) which also caused intractable epilepsy requiring surgical treatment.
Methods
: A retrospective analysis was conducted in 8 children. The history of seizures, imaging studies, electroencephalographic findings, pathologic results, and surgical outcomes were reviewed.
Results
: The onset ages of clinical seizure were from 4 days after birth to 36 months. The frequency of seizures were from multiple times a day to a few times a month. Five out of 8 FCD patients had global developmental delays with more degrees of delay in language. Only 2 out of 8 patients showed clinical partial seizures only. The scalp EEG disclosed localized interictal epileptiform activity in all 8 patients and localized continuous slow waves in 7 out of 8 patients. Ictal scalp EEG onset demonstrated a predominantly localized EEG seizure activity in 6 patients. Ictal invasive EEG findings were variable in each patient and the patterns of ictal EEG were demonstrated. Five out of 8 patients became seizure-free. One patient had one episode of seizure during the 16 months follow up period. Two patients did not have significant relief from seizures.
Conclusion
: The patients with FCD had varied spectrums of clinical manifestation, MRI and EEG findings. Five out of 8 FCD patients had complete relief from seizures, one patient has had one short, simple, partial seizure since surgery, but 2 patients with FCD in the frontal area did not experience significant relief from seizures.
Key Words: Focal cortical dysplasia, Intractable epilepsy, Electroencephalography


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