Abstract
Malformations of cortical development (MCD) are lesions produced by insult to the
developing neocortex. MCD are frequently associated with refractory epilepsy. Clinical
and electrophysiologic findings of MCD are variable. Our aims in this study are to
identify cases of MCD in patients having epilepsy, to study the semiology of seizure,
to look for associated risk factors and to correlate the semiology of seizure with
the electroencephalographic (EEG) and magnetic resonance imaging (MRI) findings. We
studied 54 patients with MCD (from January 2011 till October 2012). Detailed medical
and family histories were obtained in addition to neurological examinations and routine
EEG evaluations. There were 29 (53.7%) males and 25 (46.3%) females, with ages ranging
from 5 mo to 43 yr. The focal cortical dysplasias cases were sixteen (29.6%), schizencephaly
eight (14.8%), polymicrogyria eight (14.8%), dysembryoblastic neuroepithelial tumor
six (11.1%), lissencephaly five (9.3%), ganglioglioma three (5.6%), heterotopias three
(5.6%), hemimegalencephaly two (3.7%), cortical hamartomas of tuberous sclerosis two
(3.7%) and mixed lesion in one (1.8%). Overall, 40 (74.1%) cases had partial seizures.
The EEG revealed interictal epileptiform discharges in 27 (50.0%) with the rest being
normal. The commonest type of MCD was the focal cortical dysplasia. Most (74.1%) cases
had focal seizures. There was poor correlation between semiology of seizure with the
EEG and MRI findings. There was no history of any antenatal maternal infection or
drug exposure. No risk factor except for positive family history was identified.
Keywords
Epilepsy - malformations of cortical development - EEG
