TY - JOUR
T1 - Challenges in managing epilepsy associated with focal cortical dysplasia in children
AU - Wong-Kisiel, Lily C.
AU - Blauwblomme, Thomas
AU - Ho, Mai Lan
AU - Boddaert, Nathalie
AU - Parisi, Joseph
AU - Wirrell, Elaine
AU - Nabbout, Rima
N1 - Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/9
Y1 - 2018/9
N2 - Focal cortical dysplasia (FCD) is the most common cause of intractable focal epilepsy in children, in whom seizures are most commonly pharmacoresistant from onset. This review summarizes the current understandings of the epidemiology, natural history, and the proposed mechanisms of epileptogenisis in FCD. Advances in neuroimaging techniques have enhanced the recognition of this pathology, which can be subtle. Illustrative neurophysiology and imaging examples are provided to help the clinicians identify diagnostic evidence of suspected FCD. Given the refractory course to pharmacologic management, alternative options such as ketogenic diet, resective surgery or neuromodulation can be considered. Recognition of FCD pathology in children with early onset epilepsy should prompt timely evaluations for resective surgery, which may render a significant number of patients seizure-free and improve neurocognitive outcome.
AB - Focal cortical dysplasia (FCD) is the most common cause of intractable focal epilepsy in children, in whom seizures are most commonly pharmacoresistant from onset. This review summarizes the current understandings of the epidemiology, natural history, and the proposed mechanisms of epileptogenisis in FCD. Advances in neuroimaging techniques have enhanced the recognition of this pathology, which can be subtle. Illustrative neurophysiology and imaging examples are provided to help the clinicians identify diagnostic evidence of suspected FCD. Given the refractory course to pharmacologic management, alternative options such as ketogenic diet, resective surgery or neuromodulation can be considered. Recognition of FCD pathology in children with early onset epilepsy should prompt timely evaluations for resective surgery, which may render a significant number of patients seizure-free and improve neurocognitive outcome.
KW - Epilepsy surgery
KW - Epileptogenisis
KW - Focal cortical dysplasia
KW - Medically refractory epilepsy
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U2 - 10.1016/j.eplepsyres.2018.05.006
DO - 10.1016/j.eplepsyres.2018.05.006
M3 - Review article
C2 - 29803953
AN - SCOPUS:85047303718
SN - 0920-1211
VL - 145
SP - 1
EP - 17
JO - Epilepsy Research
JF - Epilepsy Research
ER -