Characteristics of MEG and MRI between Taylor's focal cortical dysplasia (type II) and other cortical dysplasia: surgical outcome after complete resection of MEG spike source and MR lesion in pediatric cortical dysplasia.

PURPOSE: Cortical dysplasia (CD) has been classified as Taylor's focal cortical dysplasia (FCD type II) or other CD (FCD type I and mild malformation of cortical development) based on histological findings. The aims of this study were to determine whether MRI and magnetoencephalography (MEG) could distinguish between these two groups and to evaluate surgical outcomes.

METHODS

We evaluated the MRI features, MEG spike source (MEGSS) patterns (clusters or scatters) and postsurgical seizure outcomes of 27 children with CD.

RESULTS

Thirteen patients had Taylor's FCD and 14 had other CD. MRI showed visible lesion in 22 (81%) patients. Tapering of abnormal white matter signals to the ventricles and cortical thickening were more prevalent in Taylor's FCD; focal hypoplasia and white matter atrophy were more prevalent in other CD. MEG showed spike sources in 26 (96%) patients. Taylor's FCD showed clustered MEGSSs in 6, both clustered and scattered MEGSSs in 5 and scattered MEGSSs in 2; other CD demonstrated clusters in 2, cluster and scatter in 10 and scatter in 1. Eleven (85%) of 13 patients who had complete resection of clustered MEGSSs achieved Engel class I outcome, but 4 (44%) of 9 patients with incomplete resections achieved class I. Fifteen (88%) of 17 patients who had complete resection of MRI lesions achieved class I, but 1 (33%) of 3 patients with incomplete lesionectomy was class I. There was no difference in surgical outcomes between Taylor's FCD and other CD.

CONCLUSIONS

Surgical outcome was the same in both groups following complete removal of areas containing clustered MEGSSs and MR lesions.