ABSTRACT

We aimed to review the clinical, neuroradiological and electroencephalographic (EEG) findings of patients with epilepsy and malformation of cortical development (MCD).

A retrospective analysis of the medical records of epilepsy outpatients was done. Patients with epilepsy, MCD, and ≥18 years of age were included and classified according to the Barkovich classification (BC).

The files of 2027 patients were assessed, and 17 out of 1395 epilepsy patients who were followed-up were found to have MCD. The mean age was 26.5 years. Ten patients were male and 7 were female. The mean time of seizure onset was 13 years. In terms of seizure type, 11 patients had focal, 10 had generalized tonic-clonic, 1 had absence, 1 had tonic-atonic, and 1 had myoclonic. MRI showed 7 patients with cortical dysplasia, 4 with heterotopia, 2 with periventricular nodular heterotopia, 2 with schiezencephaly, 2 with lissencephaly, 1 with agyria, 1 with pachygyria, 1 with macrogyria, 1 with polymicrogyria, and 1 with tuberous sclerosis. EEG revealed focal epileptiform discharges in 5 patients, high-frequency activity in 2, generalized epileptiform discharge in 1, diffuse disorganized background activity in 1, and focal disorganized background activity in 1. EEG was normal in 7 patients. Four of them were on monotherapy and 13 on polytherapy.

The MCDs classified in group 1 and 2 according to BC are more frequent. Treatment-resistant or good responsive cases can be seen and seizures can begin at any age. We concluded that the prevalence of MCD is 1.21%. The spectrum of epilepsy seen is extensive and the most common type of MCD is focal cortical dysplasia.

Keywords: Epilepsy, malformation of cortical development, polytherapy