Clinical Features and Seizure Outcome by Antiepileptic Drug Treatment in Epilepsies Associated with Malformations of Cortical Development
Abstract number :
2.056
Submission category :
Year :
2000
Submission ID :
3215
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Yong Jeong, Jang Sung Kim, Seung-Koo Lee, Byung In Lee, Sun Yong Kim, Yonsei Univ Coll of Medicine, Seoul, South Korea; Dept of Neurology Ajou Univ Sch of Medicine, Suwon, South Korea; Dept of Radiology Yonsei Univ Coll of Medicine, Seoul, South Korea; De
RATIONALE: Malformations of cortical development (MCD) have been recognized as an important cause of medically refractory epilepsies. However, most clinical information on epilepsies associated with MCD (EPMCD) came from patients subjected to intense presurgical investigations for their medical intractability, which might reflect only a small proportion of whole population. This study was conducted to investigate the clinical features and responses to medical treatment of various EPMCD referred to our epilepsy clinics. METHODS: Thirty-three epilepsy patients (aged 7~39 years) with MCD on MRI were recruited. We reviewed clinical/MRI characteristics and EEG findings. Firstly, we classified MCDs according to the method by Barkovich et al. (1996). Secondly, each types of MCD were correlated with clinical courses, seizure types and EEG findings. The patients were divided into remission group (RG) and non-remission group (NRG) according to the achievement of 1 year terminal remission (1yTR), which were correlated with following parameters; MCD types, seizure characteristics, EEG or other clinical/MRI features. RESULTS: Mean seizure onset age was 14.2?9.7 years. Developmental delay/neurological disability were found in 27.3%/30.3%. Heterotopia, cortical dysplasia and schizencephaly were most common. Two or more MCDs coexisted in 9.1% and other non-neocortical malformations were associated in 57.6%. In focal or lobar MCDs (n=20), IEDs of EEG and MRI findings were concordant in 10%, discordant in 70%, and not-discordant in 20%. One year TR rate was achieved in 45.5% of patients. Seizure onset age in RG (17.4?9.7 year) was significantly older than in NRG (11.5?9.0 years)(p=0.04). Other clinical features were not significantly different between the two groups (p>0.05) including neurological/developmental abnormalities, brain injury history, duration of epilepsy, seizure types, seizure number, EEG abnormality and MCD types. CONCLUSIONS: Heterotopia is the most common in EPMCD. Localizing concordance between EEG and MRI was poor. Age of onset was the single important predictor of seizure outcome.