Presurgical Characteristics and Seizure Outcomes in Patients With Focal Cortical Dysplasia Type I, II, and III: A Single-Center Study.

AIMS: This study aims to investigate the presurgical characteristics of different types of focal cortical dysplasia (FCD) and analyze the impact of these factors on postoperative seizure outcomes. METHODS: A retrospective analysis was conducted on 77 patients with histopathologically confirmed FCD, categorized into types I, II, and III. Clinical data and preoperative examinations were compared among the three groups, with significant differences analyzed using multinomial logistic regression. Cox regression was used to assess the impact of presurgical factors on postoperative seizure outcomes. RESULTS: Significant differences were found between FCD types I, II, and III in lesion location (p = 0.001) and the use of stereoelectroencephalography (SEEG) (p = 0.017). FCD type II lesions were more often extratemporal and unilateral (p < 0.05), while type I patients were more likely to require SEEG (p < 0.05). A trend toward a lower risk of seizure recurrence was observed in patients over 21 years old at the time of surgery (HR = 0.376, p = 0.045), although this association was not statistically significant after Benjamini-Hochberg false discovery rate (FDR) adjustment (FDR-adjusted p = 0.495). CONCLUSION: FCD type II lesions are predominantly extratemporal and unilateral, while SEEG is more commonly needed in type I cases. Additionally, surgical outcomes in adults are not inferior to those in children, indicating that epilepsy surgery is an effective treatment for both age groups.