Clinical and imaging characterization of malformations of cortical development in pediatric patients evaluated with epilepsy

Abstract

The study focused on cortical development malformations (CDM), a relevant factor in drug-resistant epilepsy. Barkovich's classification stood out as practical in less developed countries. Magnetic Resonance Imaging (MRI) was essential to identify and classify these CDMs. The research adopted a descriptive, non-experimental, cross-sectional, and retrospective approach. The sample consisted of pediatric patients with CDMs and/or dual pathology through imaging with epilepsy, aged 8 months to 14 years. Data collection instrument values were averaged, and hypothesis tests were conducted using the Chi-Square statistic, with a significance level of 0.05. The results characterized CDMs in pediatric patients with epilepsy. The average age was 8.71 ± 4.61 years, with a male predominance. 85% presented proliferation disorders, 40% had a history of epilepsy, and 100% had drug-resistant epilepsy. The average age of crisis onset was 3.85 ± 3.51 years, with 45% experiencing monthly crises. Motor focal onset seizures predominated, followed by focal motor onset seizures with bilateral tonic-clonic evolution and focal motor onset seizures; 100% had focal epilepsy. 65% presented anomalies in developmental milestones, 65% had behavioral alterations, 70% showed cognitive deterioration, and 35% had focal motor deficit and hypotonia. Prenatal and/or obstetric antecedents were present in 30%, while 20% had pathological antecedents. 25% presented associated brain malformations. 85% displayed focal epileptiform discharges and various structural lesions.