Congenital malformations of cortical development (MCD) are frequent underlying pathology of focal structural epilepsies in children as well as adults. MCDs form a broad group of disorders ranging from well-localized lesions in focal cortical dysplasia (FCD) type II, through lobar and multilobar involvement in FCD types I and II, to extensive malformations affecting one or both hemispheres (hemimegalencephaly, lissencephaly).
Pharmacoresistance, which is defined as the failure of two adequately selected anti-seizure drugs at the maximum tolerated doses, is reported in 65% of patients with MCD. For many patients with MCD epilepsy surgery is the only option for successful treatment.
This manuscript presents MCDs that can be treated by epilepsy surgery.