Study of Predictive Biomarkers for Rational Management of Drug-resistant Epilepsy Associated With Focal Cortical Dysplasia
Study of Predictive Biomarkers for Rational Management of Drug-resistant Epilepsy Associated With Focal Cortical Dysplasia
Focal Cortical Dysplasias (FCDs) are neurodevelopmental disorders that represent a major
 cause of early onset drug-resistant epilepsies with cognitive and behavioral impairments,
 carrying a lifelong perspective of disability and reduced quality of life. Despite a major
 medical and socio-economic burden, rationale therapeutic strategies are still under debate.
 Surgical removal of the epileptogenic brain area (Epileptogenic Zone) is the most successful
 treatment, yet it fails to control FCD-associated seizures in as much as 40% of cases.
 Precise definition and complete resection of the Epileptogenic Zone are the main determinants
 of outcome. In current practice of French centers, up to 80% FCD-patients require an
 intracranial EEG (icEEG) recording to accurately define the epileptogenic zone. However, the
 indications for icEEG in MRI-visible FCD remain empirical and are essentially based on expert
 opinion.
Inclusion Criteria:

 -  Adult or pediatric patient suffering from drug-resistant focal epilepsy;

 -  Age more than 2 years old;

 -  Brain MRI suggestive of FCD or normal;

 -  Standardized presurgical evaluation available including medical history, scalp
 video-EEG, 3T MRI, FDG-PET, Neuropsychological tests;

 -  Inpatient in one of the participating centers for recording seizure during long term
 scalp video-EEG and / or SEEG-monitoring;

 -  Resective surgery with a minimal post-operative follow-up of 12 months;

 -  Histopathologic evidence for FCD or non-pathologic findings (normal histology or mMCD
 type II).

 -  Patient, parents or legally representative who have given written informed consent to
 allow the study data collection procedures.

 Exclusion Criteria:

 -  Brain MRI suggestive of another type of lesion;

 -  Difficulty to read or understand French, or inability to understand the information;

 -  Pregnant or breastfeeding woman;

 -  Subject under judicial protection.

 -  Other lesion discovered on histological examination;

 -  FCD type 3, dual pathology, ambiguous or unavailable neuropathological findings

 -  Lack of longitudinal pre- and post-surgical follow-up.