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Characteristics of epilepsy in focal cortical dysplasia in infancy

Anne Lortie1, Perrine Plouin, Catherine Chiron

  • 1Paediatric Neurology and EEG Services, Hôpital Sainte-Justine, 3175 Côte Sainte-Catherine, Montreal, Que, Canada H3T 1C5. lortie.a@sympatico.ca

Epilepsy Research
|September 28, 2002
PubMed

Insights

Focal cortical dysplasia (FCD) causes early, difficult-to-treat infantile epilepsy. While infantile spasms (IS) respond to medication, partial seizures often require early surgery for better neurodevelopmental outcomes.

Area of Science:

  • Neurology
  • Pediatric Epilepsy
  • Neurodevelopmental Disorders

Background:

  • Focal cortical dysplasia (FCD) is a leading cause of epilepsy in infants.
  • Characteristics of FCD-related epilepsy in infancy are not well-documented.
  • Understanding FCD epilepsy is crucial for timely intervention and management.

Purpose of the Study:

  • To delineate the clinical characteristics of epilepsy associated with FCD in infants.
  • To evaluate the response to medical and surgical treatments for FCD-induced seizures.
  • To assess the neurodevelopmental outcomes in infants with FCD and epilepsy.

Main Methods:

  • Retrospective study of 28 infants diagnosed with FCD.
  • Analysis of seizure semiology, age of onset, and psychomotor development.
  • Evaluation of treatment responses (medical and surgical) and neurodevelopmental findings.

Main Results:

  • All patients presented with early partial seizures; semiology varied with dysplasia location.
  • Infantile spasms (IS) occurred in 11 patients, were mainly asymmetrical, and responded to Vigabatrin or ACTH.
  • Partial seizures were refractory to medical treatment; 15/28 underwent surgery, with 8 becoming seizure-free and 7 showing psychomotor improvement.

Conclusions:

  • Early-onset, refractory partial seizures characterize FCD in infancy, with easily controlled IS.
  • Focal ictal semiology can aid in localizing FCD; intrinsic epileptogenicity likely drives the clinical pattern.
  • Given poor medical control and neurodevelopmental prognosis, early surgical consideration is vital for infants with FCD.

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