Cortical laminar disorganization is correlated with severity of the cortical dysplasia and surgical outcome - experience with 150 cases

The aim of this study is to evaluate that the cortical laminar disorganization (CLD) and its correlation with the severity of the cortical dysplasia (CD) and surgical outcome. The cohort consists of 150 patients (101 males and 49 females) who underwent surgical resection of the epileptic area due to medically intractable epilepsy. Histologically, the CLD was divided into three grades according to the degree of disarrangement of the clear-cut six-layered cortex and the pathological features on MAP2 and NeuN immunostaining; normal to mild, moderate and severe CLD in 58 (38.7%), 47 (31.3%) and 45 (30.0%) cases, respectively. The histopathological grading of CLD had significant correlation with severity of CD (p < 0.001), number of single heterotopic neurons in white matter (p = 0.009), presence of neurons in molecular layer (p < 0.001), persistent subpial granular cells (p = 0.017), cytomegalic neurons (p < 0.001) and balloon cells (p < 0.001), and gray-white matter blurring (p < 0.001),. and had inverse correlation with surgical outcome (<0.001). Since statistically correlated with the known parameters of CD and surgical outcome, the grading of CLD could be used as another histological parameter for CD. (C) 2004 Elsevier B.V. All rights reserved.