Prognostic analysis of children with focal cortical dysplasia taking Transmantle sign as the main MRI performance_Journal of Epilepsy

Authors：

LI Lin ¹ , SUN Zhiqun ² , ZHAO Jianshe ¹ , CUI Ruodi ¹ ,  LI Fangyuan ³

1. The Center of Medical Imaging, Qilu Children’s Hospital of Shandong University, Jinan 250022, China;
2. New Pediatricl Department, Weifang People’s Hospital of Shandong Province, Weifang 261071, China;
3. Department of Imaging, Jinan Southern Suburb Hospital, Jinan 250000, China;

Corresponding author：

LI Fangyuan, Email: lifangyuan313@163.com

Keywords：

Children; Focal cortical dysplasia; Tansmantle sign; Magnetic resonance imaging; Neurosurgical procedures; Prognosis

DOI：

10.7507/2096-0247.202112013

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Objective Discussed the postoperative seizure control situation of children with focal cortical dysplasia (FCD),which took Transmantle sign (T2WI or T2 FLAIR sequence inward extension cone high signal in the direction of ventricle) as the main MRI performance, and analyzed the influence of various factors on the prognosis of surgery.Methods Retrospective analysis was performed on 56 children with FCD with Transmantle signs as the main MRI signs confirmed by pathology in Qilu Children's Hospital of Shandong University from May 2015 to March 2020, including 33 males and 23 females, with an average age of (4.8±0.13) years old, and their imaging and clinical data were analyzed. Analyzed the pathological types and main MRI signs, the range of epileptiform discharge, and Engel classification after surgery. Analyzed the effect of surgical method, type of onset, age of operation, epileptic site, course of disease and perioperative epileptic seizure on the surgical prognosis of children.Results Postoperative pathology showed that all the 56 cases both were FCDⅡb, in addition to the Transmantle sign, the MRI performance were also accompanied by focal blurring of gray and white matter, abnormal cortical structure, and abnormal signal foci in gray and white matter. Intraoperative EEG monitoring results showed that the epileptiform discharge area in all cases was larger than the lesion range showed by MRI. Postoperative Engel classification: 25 cases of gradeⅠ (43.8%), 18 cases of gradeⅡ (31.3%), 4 case of gradeⅢ (6.3%), 9 cases of gradeⅣ (18.8%). Surgical resection and perioperative seizures are independent factors affecting the prognosis of children (P<0.05).Conclusion surgical methods and perioperative seizures were closely related to the prognosis of children.

Citation： LI Lin, SUN Zhiqun, ZHAO Jianshe, CUI Ruodi, LI Fangyuan. Prognostic analysis of children with focal cortical dysplasia taking Transmantle sign as the main MRI performance. Journal of Epilepsy, 2022, 8(3): 217-221. doi: 10.7507/2096-0247.202112013 Copy

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2.	Kakita A. Surgical pathologic features of cerebral cortical lesions taken from 600 patients with intractable epilepsy. Brain Dev, 2013, 35(8): 793-801.
3.	Jin B, Krishnan B, Adler S, et al. Automated detection of focal cortical dysplasia type II with surface-basedmagnetic resonance imaging postprocessing and machine learning. Epilepsia, 2018, 59(5): 982-992.
4.	Chen J, Chen X, Huang C, et al. Predictors of seizure recurrence in patients with surgery for focal cortical dysplasia: pairwise and network meta-analysis and trial sequential analysis. Childs Nerv Syst, 2019, 35(5): 753-767.
5.	Sakaguchi Y, Kidokoro H, Ogawa C, et al. Longitudinal findings of MRI and PET in West syndrome with subtle focal cortical dysplasia. Am J Neuroradiol, 2018, 39(10): 1932-1937.
6.	Ahmed R, Rubinger L, Go C, et al. Utility of additional dedicated high-resolution 3T MRI in children with medically refractory focal epilepsy. Epilepsy Res, 2018, 143: 113-119.
7.	Hong SJ, Bernhardt BC, Caldairou B, et al. Multimodal MRI profiling of focal cortical dysplasia type II. Neurology, 2017, 88(8): 734-742.
8.	Jayalakshmi S, Nanda SK, Vooturi S, et al. Focal cortical dysplasia and refractory epilepsy: role of multimodality imaging and outcome of surgery. AJNR Am J Neuroradiol, 2019, 40(5): 892-898.
9.	Choi SA, Kim KJ. The surgical and cognitive outcomes of focal cortical dysplasia. J Korean Neurosurg Soc, 2019, 62(3): 321-327.
10.	Ma D, Jones SE, Deshmane A, et al. Development of high-resolution 3D MR fingerprinting for detection and characterization of epileptic lesions. J Magn Reson Imaging, 2019, 49(5): 1333-1346.
11.	Bourdillon P, Rheims S, Catenoix H, et al. Malformations of cortical development: new surgical advances. Rev Neurol (Paris), 2019, 175(3): 183-188.
12.	Jin B, Wang J, Zhou J, et al. A longitudinal study of surgical outcome of pharmacoresistat epilepsy caused by focal cortical dysplasia. J Neurol, 2016, 263(12): 2403-2410.
13.	Ramírez MJL, Di Giacomo R, Mariani V, et al. Surgical outcomes in two different age groups with Focal Cortical Dysplasia type II: Any real difference? Epilepsy Behav, 2017, 70(Pt A): 45-49.
14.	Mata-Mbemba D, Iimura Y, Hazrati LN, et al. MRI, magnetoencephalography, and surgical outcome of oligodendrocytosis versus focal cortical dysplasia type I. Am J Neuroradiol, 2018, 39(12): 2371-2377.
15.	Kwon HE, Eom S, Kang HC, et al. surgical treatment of pediatric focal cortical dysplasia: clinical spectrum and surgical outcome. Neurology, 2016, 87(9): 945-951.
16.	Fauser S, Essang C, Altenmüller DM, et al. Long-term seizure outcome in 211 patients with focal cortical dysplasia. Epilepsia, 2015, 56(1): 66-76.

1. Blümcke I, Thom M, Aronica E, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission Epilepsia, 2011, 52(1): 158-174.
2. Kakita A. Surgical pathologic features of cerebral cortical lesions taken from 600 patients with intractable epilepsy. Brain Dev, 2013, 35(8): 793-801.
3. Jin B, Krishnan B, Adler S, et al. Automated detection of focal cortical dysplasia type II with surface-basedmagnetic resonance imaging postprocessing and machine learning. Epilepsia, 2018, 59(5): 982-992.
4. Chen J, Chen X, Huang C, et al. Predictors of seizure recurrence in patients with surgery for focal cortical dysplasia: pairwise and network meta-analysis and trial sequential analysis. Childs Nerv Syst, 2019, 35(5): 753-767.
5. Sakaguchi Y, Kidokoro H, Ogawa C, et al. Longitudinal findings of MRI and PET in West syndrome with subtle focal cortical dysplasia. Am J Neuroradiol, 2018, 39(10): 1932-1937.
6. Ahmed R, Rubinger L, Go C, et al. Utility of additional dedicated high-resolution 3T MRI in children with medically refractory focal epilepsy. Epilepsy Res, 2018, 143: 113-119.
7. Hong SJ, Bernhardt BC, Caldairou B, et al. Multimodal MRI profiling of focal cortical dysplasia type II. Neurology, 2017, 88(8): 734-742.
8. Jayalakshmi S, Nanda SK, Vooturi S, et al. Focal cortical dysplasia and refractory epilepsy: role of multimodality imaging and outcome of surgery. AJNR Am J Neuroradiol, 2019, 40(5): 892-898.
9. Choi SA, Kim KJ. The surgical and cognitive outcomes of focal cortical dysplasia. J Korean Neurosurg Soc, 2019, 62(3): 321-327.
10. Ma D, Jones SE, Deshmane A, et al. Development of high-resolution 3D MR fingerprinting for detection and characterization of epileptic lesions. J Magn Reson Imaging, 2019, 49(5): 1333-1346.
11. Bourdillon P, Rheims S, Catenoix H, et al. Malformations of cortical development: new surgical advances. Rev Neurol (Paris), 2019, 175(3): 183-188.
12. Jin B, Wang J, Zhou J, et al. A longitudinal study of surgical outcome of pharmacoresistat epilepsy caused by focal cortical dysplasia. J Neurol, 2016, 263(12): 2403-2410.
13. Ramírez MJL, Di Giacomo R, Mariani V, et al. Surgical outcomes in two different age groups with Focal Cortical Dysplasia type II: Any real difference? Epilepsy Behav, 2017, 70(Pt A): 45-49.
14. Mata-Mbemba D, Iimura Y, Hazrati LN, et al. MRI, magnetoencephalography, and surgical outcome of oligodendrocytosis versus focal cortical dysplasia type I. Am J Neuroradiol, 2018, 39(12): 2371-2377.
15. Kwon HE, Eom S, Kang HC, et al. surgical treatment of pediatric focal cortical dysplasia: clinical spectrum and surgical outcome. Neurology, 2016, 87(9): 945-951.
16. Fauser S, Essang C, Altenmüller DM, et al. Long-term seizure outcome in 211 patients with focal cortical dysplasia. Epilepsia, 2015, 56(1): 66-76.

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