brain_development [Neurosurgery Wiki]

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Extensive [[multilobar cortical dysplasia]] in [[infant]]s commonly is first seen with [[catastrophic epilepsy]] and poses a therapeutic challenge with respect to control of [[epilepsy]], [[brain development]], and psychosocial outcome. Experience with surgical treatment of these lesions is limited, often not very encouraging, and holds a higher [[operative risk]] when compared with that in older children and adults.

Two infants were evaluated for surgical control of catastrophic epilepsy present since birth, along with a significant psychomotor developmental delay. [[Magnetic resonance imaging]] showed multilobar [[cortical dysplasia]] (temporoparietooccipital) with a good electroclinical correlation. They were treated with a [[temporal lobectomy]] and posterior [[parietooccipital disconnection]].

Both infants had excellent postoperative recovery and at follow-up (1.5 and 3.5 years) evaluation had total control of [[seizure]]s with a definite "catch up" in their development, both motor and cognitive. No long-term complications have been detected to date.

The incorporation of [[disconnective technique]]s in the surgery for extensive multilobar cortical dysplasia in infants has made it possible to achieve excellent seizure results by maximizing the extent of surgical treatment to include the entire [[epileptogenic zone]]. These techniques decrease perioperative [[morbidity]], and Daniel RT et al. believe would decrease the potential for the development of long-term complications associated with large brain excision
((Daniel RT, Meagher-Villemure K, Roulet E, Villemure JG. Surgical treatment of 
temporoparietooccipital cortical dysplasia in infants: report of two cases.
Epilepsia. 2004 Jul;45(7):872-6. PubMed PMID: 15230716.
)).