Table 1.
Patient preoperative epilepsy syndrome, PMG characteristics, surgery description, and seizure control outcome
Pt | Age, sex | Age onset | Preop seizure type | PMG type and associated imaging findings | Epilepsy syndrome | Surgery performed | Engel |
---|---|---|---|---|---|---|---|
1 | 3 month, F | Birth | Focal dyscognitive | Multifocal left PMG of frontal pole, convexity and frontal and parietal opercula with transmantle cortical dysplasia and hemimegalencephaly | Not available | Left hemispherectomy | Ia |
2 | 1 year, F | Birth | ES, focal motor | Diffuse left PMG with hemimegalencephaly, pachygyria and subependymal heterotopia | Focal refractory with ES, symptomatic of MCD | Left functional hemispherectomy | Ia |
3 | 9 year, M | 6 year | Focal motor and dyscognitive, SGTCS, SE, atypical absences, and ESES | Bilateral temporal occipital polymicrogyria, bilateral parietal and occipital while matter volume loss and thinning of the posterior corpus callosum | ESES | Right occipital seizure foci resection | Ia |
4 | 34 year, M | 26 year | Focal ± dyscognitive, motor or SGTCS | Right occipital polymicrogyria extending from occipital pole to calcarine sulcus and to posteromedial aspect of occipital horn of lateral ventricle | Focal refractory, symptomatic of MCD | Right occipital seizure foci resection | Ia |
5 | 30 year, F | 11 year | Focal ± dyscognitive, motor or SGTCS | Focal right perisylvian polymicrogyria with involvement of the frontal, parietal and temporal lobes | Not available | 1. Right frontal seizure foci resection | Ic |
2. VNS | |||||||
6 | 38 year, M | 26 year | Focal dyscognitive ± SGTCS | Right temporal lobe polymicrogyria with cortical dysplasia | Focal refractory, symptomatic of MCD | Right frontoparietal and temporal seizure foci resection | Ic |
7 | 36 year, F | Child hood | Focal dyscognitive with aphasia and motor symptoms ± SGTCS | Bilateral perisylvian polymicrogyria with left closed-lip schizencephaly | Focal refractory, symptomatic of MCD | Left frontotemporal seizure foci resection | IIc |
8 | 4 month, M | 4 month | Focal motor ± SGTCS | Focal right frontal polymicrogyria involving operculum, anterior insula, orbital gyri, reduced white matter volume | Focal refractory, symptomatic of MCD | 1. Right frontal seizure foci resection | IIIa |
2. Right functional hemispherectomy | |||||||
9 | 10 year, M | 5 year | Focal sensory and motor ± SGTCS | Bilateral occipital lobe polymicrogyria with left parietal gross architectural distortion likely from in utero insult | Focal refractory, symptomatic of MCD | Left functional hemispherectomy | IIIa |
10 | 44 year, F | 18 year | Focal dyscognitive with aphasia ± SGTCS | Left greater than right bilateral posterior perisylvian polymicrogyria extending to parietal operculum | Focal refractory, symptomatic of MCD | Right anterior temporal, inferior frontal and parietal seizure foci resection | IIIa |
11 | 2 year, M | 2 month | ES, focal motor | Focal right perisylvian PMG and hemimegalencephaly | Focal refractory with ES, symptomatic of MCD | Right functional hemispherectomy | IVb |
12 | 16 year, M | 3.5 year | Focal motor ± dyscognitive, ±SGTCS | Focal left perisylvian polymicrogyria with left hippocampal atrophy and nodular heterotopia of the occipital horn | Focal refractory, symptomatic of MCD | Left superior temporal, peri-insula, and parietal seizure foci resection | IVb |
PMG, polymicrogyria; FU, follow-up; SGTCS, secondary generalized tonic–clonic seizures; ES, epileptic spasm; SE, status epilepticus; ESES, electrical status epilepticus during sleep; MCD, malformation of cortical development; VNS, vagus nerve stimulator.