AYŞE KARTAL, Kürşad AYDIN

Malformations of cortical development and epilepsy: Clinical, EEG and neuroimaging findings in children

Amaç: Bu çalışmada kortikal gelişim bozukluğu olan çocuklarda klinik özellikler ve tedavi bulguları arasındaki iliş- kinin değerlendirilmesi amaçlanmıştır. Yöntemler: Kortikal gelişim bozukluğuna sahip 40 hastanın EEG bulguları, tedavi, klinik ve nörogörüntüleme bulguları detaylı bir şekilde değerlendirilmiştir. Bulgular: Olguların değerlendirilme anındaki yaşları 4-17 yaş aralığında ve ortalama yaşları 5,4 yıldı. %57,5i erkek, %12,2sinde epilepsi ve diğer nörolojik hastalık açı- sından pozitif aile öyküsü, %15inde ise gebelik ya da doğum sonrası döneme ait travma öyküsü vardı. Olguların %70inde nöromotor gelişim basamaklarında gerilik tespit edildi. Her tür nöbet tipi görülmesine karşın en sık gözlenen nöbet tipi jeneralize nöbetlerdi (%45). Olguların %32,5i tek antiepileptik ilaç alırken, %67,5i çoklu antiepileptik ilaç kullanmaktaydı. Tam nöbet kontrolü olguların %45,5inde sağlanırken, %17,5inde kısmi kontrol sağlanmıştı. Olguların %35inde ise nöbet kontrolü sağlanamamıştı. Serimizde lizensefali, şizensefali ve polimikrogiri en sık görülen kortikal gelişim bozukluklarıydı. Şizensefali ve polimikrogirisi olan olgularda epilepsi kontrolü sağlanırken lizensefali ve hemimegalensefalili olgularda nöbet kontrolü sağlanamamıştı. Sonuç: Kortikal gelişim bozukluğu gelişme geriliği, zeka geriliği ve medikal tedaviye dirençli epilepsi gibi geniş bir klinik yelpazeden sorumludur.

Kortikal gelişim bozukluğu ve epilepsi: Çocuklarda klinik, EEG ve nörogörüntüleme bulguları

Objective: of this study was to evaluate the relationship between clinical and treatment features of malformations of cortical development (MCD) in children Methods: We performed a comprehensive analysis of EEG features, treatment, clinical and neuroimaging findings in 40 consecutive patients. Results: We are reporting a series of 40 cases with cortical malformation and epilepsy. The ages of our patients at the time of evaluation varied between 4 month and 17 years with a mean of 5.4 years. 57.5% were male and 12.2% of the cases had a family history of epilepsy or other neurological disease, and 15% had gestational or a perinatal insult. Delayed motor and mental milestones were observed in 70%. All type of seizures were reported, but generalized seizures was the most common (18/40, 45%). Patients were on either a single antiepiletic drug (13/40, 32.5 %) or multiple drugs (27/40, 67.5%). Complete seizure control was achieved in 19/40 patients (45.5%), partial control in 7/40 (17.5%) patients, and no control in 14/40 (35%). Lissencephaly, schizencephaly and polymicrogyria were seen as the most common neuroimaging findings in our study. Epilepsy was controlled in most patients with schizencepahly and polymicrogyria. In contrast, seizures were not controlled in patients with lissencephaly and hemimegalencephaly. Conclusion: Malformations of cortical development are responsible for a wide spectrum of clinical manifestations that include develomental delay, mental retardation and medically refractory epilepsy.

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