A retrospective analysis of epilepsy patients with focal cortical dysplasia type II (FCD2) suggests that epilepsy surgery is an effective treatment for this group with limited risks of long-term adverse effects. French researchers report this in Neurology.
Because in patients with FCD2 the epileptogenic zone is frequently located in the vicinity of brain regions involved in language, these patients were often not eligible for epilepsy surgery. In recent years, however, this has changed due to improvements in imaging and surgical techniques, the French researchers write, leading to an increasing number of successful operations. With a single-center, retrospective analysis of 60 operated patients, they investigated the effects on epilepsy and the adverse effects patients experienced.
The participants often had epilepsy from a young age and had a high frequency of seizures (30-90 per day). After surgery, 88% were seizure free (n = 53), with 62% having Engel Class IA (n = 37). In addition, there were two patients who were almost seizure free and five patients with a significant improvement in symptoms. The use of antiepileptic drugs had also decreased; 47% had completely stopped and subsequently remained seizure free.
Motor disturbances occurred in 52 patients shortly after surgery, but complete recovery was eventually achieved in 21. The 31 patients with persistent disorders for more than two years had mainly mild complaints (mild; 19, mean; 9, severe; 3).
The researchers conclude that epilepsy surgery for central FCD2 resections resulted in seizure control in most patients without lasting severe impairment.
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