A New Perspective on Drug-Resistant Epilepsy in Children with Focal Cortical Dysplasia Type 1: From Challenge to Favourable Outcome

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F68407700%3A21230%2F25%3A00378751" target="_blank" >RIV/68407700:21230/25:00378751 - isvavai.cz</a>

Result on the web

<a href="https://doi.org/10.1111/epi.18237" target="_blank" >https://doi.org/10.1111/epi.18237</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/epi.18237" target="_blank" >10.1111/epi.18237</a>

Result language

angličtina

Original language name

A New Perspective on Drug-Resistant Epilepsy in Children with Focal Cortical Dysplasia Type 1: From Challenge to Favourable Outcome

Original language description

Objectives: We comprehensively characterised a large paediatric cohort with focal cortical dysplasia (FCD) type 1 to expand phenotypic spectrum and to identify predictors of postsurgical outcomes. Methods: We included paediatric patients with histopathological diagnosis of isolated FCD type 1 and at least one year of postsurgical follow-up. We systematically re-analysed clinical, electrophysiological, and radiological features. The results of this re-analysis served as independent variables for subsequent statistical analyses of outcome predictors. Results: All children (N=31) had drug-resistant epilepsy with varying impacts on neurodevelopment and cognition (presurgical intelligence quotient (IQ)/developmental quotient scores: 32–106). Low presurgical IQ was associated with abnormal slow background EEG activity and disrupted sleep architecture. Scalp EEG showed predominantly multiregional and often bilateral epileptiform activity. Advanced epilepsy MRI protocols identified FCD-specific features in 74.2% of patients (23/31), 17 of whom were initially evaluated as MRI-negative. In six out of eight MRI-negative cases, fluorodeoxyglucose-PET and subtraction ictal single-photon emission computed tomography co-registered to MRI (SISCOM) helped localise the dysplastic cortex. Sixteen patients (51.6%) underwent invasive EEG. By the last follow-up (median 5 years, interquartile range 3.3–9 years), seizure freedom was achieved in 71% of patients (22/31), including 7 out of 8 MRI-negative patients. Anti-seizure medications were reduced in 21 patients, with complete withdrawal in six. Seizure outcome was predicted by a combination of the following descriptors: age at epilepsy onset, epilepsy duration, long-term invasive EEG, and specific MRI, and PET findings. Significance: This study highlights the broad phenotypic spectrum of FCD type 1, which spans far beyond the narrow descriptions of previous studies. The applied multi-layered presurgical approach helped localise the epileptogenic zone in many previously non-lesional cases, resulting in improved postsurgical seizure outcomes, which are more favourable than previously reported for FCD type 1 patients.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30210 - Clinical neurology

Project

Result was created during the realization of more than one project. More information in the Projects tab.

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Epilepsia

ISSN

0013-9580

e-ISSN

1528-1167

Volume of the periodical

66

Issue of the periodical within the volume

3

Country of publishing house

US - UNITED STATES

Number of pages

16

Pages from-to

632-647

UT code for WoS article

001383241100001

EID of the result in the Scopus database

2-s2.0-85213012062