Cortical microdysplasia and surgical outcome in refractory epilepsy of childhood

This paper examines the relationship between the degree and type of cortical microdysplasia as reported on pathological examination and the degree of seizure control after cortical resection in 70 children with medically refractory epilepsy. Cases selected for this review had to have had medically refractory epilepsy; had their first cortical resection before the age of 18 years, and have sufficient pathological material available for review. The pathological review was done blinded as to results of seizure control outcome postsurgery. Pathological material was classified to type and degree of microdysplasia, according to the classification scheme of Brannstrom. 11% of patients had no evidence of dysplasia; 77% had microdysplasia type 2, and 12% had focal dysplasia (type 3). No significant correlation between degree of seizure control postoperatively and type of microdysplasia was seen in this series.