Influencing factors of surgical outcomes for drug-resistant temporal lobe epilepsy caused by focal cortical dysplasia in children

XIONG Peng-ju; CHEN Qi-long; HE Lin; LIU Qing

doi:10.13798/j.issn.1009-153X.2025.08.007

Abstract：Objective To investigate the surgical outcomes and influencing factors for drug-resistant temporal lobe epilepsy(TLE)caused by focal cortical dysplasia(FCD)in children.Methods A retrospective analysis was conducted on the clinical data of 60 children with drug-resistant TLE who underwent surgical treatment between January 2017 and June 2019.At the last postoperative follow-up,seizure control outcomes were assessed using the Engel classification,with Engel Class Ⅰ indicating favorable seizure control.Results Postoperative pathological findings diagnosed all cases as FCD type Ⅲ.Preoperative MRI:36 cases exhibited typical features of hippocampal sclerosis,while 24 cases were MRI-negative.Among the MRI-negative patients,17(70.83％)were identified as FCD type Ⅲa.The complete resection rate of the epileptogenic zone was significantly lower in MRI-negative patients(70.83％)compared to MRI-positive patients(97.22％;P=0.005).At the 2-year postoperative follow-up,35 cases(58.33％)achieved favorable seizure control;at the 5-year postoperative follow-up,42 cases(70.0％)exhibited favorable seizure control.Multivariate logistic regression analysis revealed that longer disease duration and MRI-negative status were independent risk factors for poor postoperative seizure control(P<0.05),while complete resection of the epileptogenic zone was a protective factor for favorable postoperative seizure control(P<0.05).Conclusion The majority of children with FCD type Ⅲ drug-resistant TLE achieved favorable seizure control following surgical treatment.MRI-negative status affects the complete resection rate of the epileptogenic zone in children,leading to suboptimal postoperative seizure control outcomes.