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Neuroimaging in identifying focal cortical dysplasia and prognostic factors in pediatric and adolescent epilepsy surgery.

Authors
 Yoon Hee Kim  ;  Hoon-Chul Kang  ;  Dong-Seok Kim  ;  Se Hoon Kim  ;  Kyu-Won Shim  ;  Heung Dong Kim  ;  Joon Soo Lee 
Citation
 EPILEPSIA, Vol.52(4) : 722-727, 2011 
Journal Title
 EPILEPSIA 
ISSN
 0013-9580 
Issue Date
2011
MeSH
Adolescent ; Brain Diseases/complications ; Brain Diseases/diagnosis ; Brain Diseases/surgery ; Brain Mapping/methods ; Cerebral Cortex/diagnostic imaging ; Cerebral Cortex/pathology* ; Child ; Child, Preschool ; Epilepsy/diagnosis* ; Epilepsy/etiology* ; Epilepsy/surgery ; Female ; Humans ; Infant ; Magnetic Resonance Imaging/methods ; Male ; Malformations of Cortical Development/complications ; Malformations of Cortical Development/diagnosis ; Malformations of Cortical Development/surgery ; Malformations of Cortical Development, Group I ; Positron-Emission Tomography/methods ; Prognosis ; Young Adult
Keywords
Neuroimaging ; Cortical dysplasia ; Pediat-ric and adolescent epilepsy surgery.
Abstract
PURPOSE: The purpose of this study is to determine the sensibility of each imaging tool in identifying focal cortical dysplasia (FCD) in children and adolescents with epilepsy and to define the prognostic factors of pediatric and adolescent epilepsy surgery. METHODS: We identified 48 children with FCD who underwent resective surgery and analyzed their preoperative data. The results of various anatomic and functional neuroimaging studies were compared for accuracy in locating the lesion. We also investigated clinical factors that affected the outcome of surgical treatment. KEY FINDINGS: Brain magnetic resonance imaging (MRI) was able to localize FCD in 30 patients and fluorodeoxyglucose positron emission tomography (FDG-PET) and/or subtraction ictal single photon emission computed tomography (SPECT) coregistered with MRI provided additional information that helped to define the lesion in 13 patients. When comparing the pathologic results between a mild malformation of cortical development (MCD) and FCD type I and II, we noted a strong tendency for patients with FCD to have MRI abnormalities (p = 0.005). In addition, severe pathologic features (Palmini's classification, FCD type II) (p = 0.025) showed significant correlation with a better surgical outcome. To define the primary epileptogenic area, various interictal epileptiform discharges and the results of multimodal neuroimaging studies were helpful, and younger age at the time of operation could aid in more favorable surgical outcomes (p = 0.048). SIGNIFICANCE: Our study showed a significant relationship between pathologic grade and the detectability of FCD by brain MRI. In addition, early surgery can be justified by showing that advanced neuroimaging studies in children with FCD and even with extensive epileptiform discharges have a higher rate of success.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2010.02950.x/abstract
DOI
10.1111/j.1528-1167.2010.02950.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hoon Chul(강훈철) ORCID logo https://orcid.org/0000-0002-3659-8847
Kim, Dong Seok(김동석)
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92823
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