Focal Cortical Dysplasia (FCD) and Hippocampal Sclerosis (HS) patients often present with seizures or pits which are drug resistant in nature. These patients can be seizure-free after lesion resection. However some still experience seizures after surgery. The present study aimed to analyze the clinical data of a group of FCD and HS allied partial epilepsy patients and evaluate their seizure outcomes and prognostic factors. Follow-up study involved clinical data collected from medical records of patients diagnosed with FCD and HS pathologically and underwent surgical resection in Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad. The seizure outcomes were evaluated based on the International League against Epilepsy (ILAE) classification. The prognostic factors were identified according to univariate and multivariate analysis. A total of 576 (FCD = 174; HS = 402) patients were included, with a mean age at surgery of 17.32 ± 8.34 years for FCD and 10.74 ± 7.24 years for HS. All patients were followed up at least for one year with a mean follow-up duration of 7.98 ± 3.84 years. At the final follow-up, 89 (51.6%) of FCD and 324 (80.5%) of HS patients achieved ILAE Class 1 or 2. Univariate and multivariate analyses revealed that the short duration of seizures and gross total resection were significant positive factors for seizure-free. Bilateral interictal or ictal epileptiform discharges in preoperative video-electroencephalogram (VEEG) were related to poor seizure outcomes. Surgical resection is an effective treatment for patients with FCD and HS-associated partial epilepsy. The analysis of predictive factors could effectively guide clinical practice and evaluate the prognosis of drug-resistant epilepsy.

Keywords: Focal Cortical Dysplasia; Hippocampal Sclerosis; Partial Epilepsy; Surgical Resection; Seizure Outcome; Prognostic Factors