Clinical characteristics and prognosis of focal cortical dysplasia with epilepsy in children

OBJECTIVE: To characterize the clinical features of epilepsy related to focal cortical dysplasia ( FCD) in children and to identify factors associated with favorable postoperative outcomes. METHODS: Clinical data from 97 pediatric patients with FCD-related epilepsy who underwent surgical treatment were retrospectively collected and analyzed. Patients were categorized into good outcome and poor outcome groups according to Engel grading. Univariate and multivariate analyses were performed to identify factors associated with favorable prognosis. RESULTS: A total of 97 patients were included. Focal seizures were the most common seizure type, occurring in 72 patients. Magnetic resonance imaging (MRI) revealed positive findings in 82 patients. Ictal video-EEG (VEEG) demonstrated low-voltage fast activity in 46 patients, while interictal VEEG showed predominantly focal epileptiform discharges in 70 patients. Pathological examination revealed FCD type I in 17 patients, type II in 56, and type III in 24. At the most recent follow-up, 77 patients achieved Engel class I, 10 achieved class II, 5 achieved class III, and 5 achieved class IV. Univariate analysis identified focal interictal discharges on VEEG, epileptogenic focus resection, FCD type II, and temporal lobe lesion location as significant factors associated with good outcomes (P < 0.05). Multivariate analysis confirmed that epileptogenic focus resection, FCD type II, and temporal lobe location were independent predictors of favorable postoperative outcomes (P < 0.05). CONCLUSION: Most children with FCD-related epilepsy in this cohort achieved favorable postoperative outcomes. Epileptogenic focus resection, FCD type II pathology, and temporal lobe lesion location were identified as independent factors associated with good prognosis.