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Cortical Dysplasia

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Cortical dysplasia occurs before a child is born, when developing brain cells, or neurons, fail to reach the parts of the brain for which they are genetically destined. As a result, those areas of the brain lack the appropriate neural connections to function properly. This condition is one of the most common causes of epilepsy and seizures.

Cortical dysplasia is one of the most common types of epilepsy in children and is often associated with seizures that are difficult to control with medications. You will be glad to know that the Epilepsy Center at Children’s Health is a Level 4 Epilepsy Center, providing the highest level of treatment for children with epilepsy. That means we have experience identifying the genetic condition that causes cortical dysplasia, and in treating the condition.

We were the first such program in the country to be certified by the Joint Commission, the nation’s preeminent standard-setting accrediting and certifying regulatory body in healthcare. Our interdisciplinary medical team has the experience to not only comprehensively diagnose children with this condition, but we remain the area’s only center to perform the most advanced procedures and therapies for the treatment of epilepsy.

Because this condition affects your child and your family, you will be glad to know we provide care for the whole family, including education and support.

In addition, the Epilepsy Center works with referring physicians and area Emergency Departments to:

  • Provide seizure safety education programs
  • Expedite appointments in order to get your child evaluated quickly
Symptoms

Symptoms

The most common symptom of cortical dysplasia are seizures. Seizures include:

Tonic-clonic seizure. This type of seizure can involve shaking (called convulsions) combined with the body getting rigid, clenching the jaw, and biting the tongue. Some people still know this type of seizure as a grand mal seizure.

Absence seizure. This type of seizure may involve staring into space. Or your child may stop talking abruptly and then start talking again, or start repetitious movements like chewing their lips or moving a hand. These types used to be known as petit mal seizures.

Sometimes, before a seizure, your child may experience an aura, which results in your child smelling something that isn’t there, or in numbness or a tingling sensation. 

Tests and Diagnosis

Tests and Diagnosis

To diagnose epilepsy, your physician will do a detailed physical exam of your child, ask you about your child’s past medical history and family history, and learn as much as possible from you about how a seizure started and what you observed. If cortical dysplasia is suspected, testing may be prescribed including EEG and a tissue sample.

Treatments

Treatments

Treatment for cortical dysplasia is focused on controlling the seizures. If your child is diagnosed with epilepsy, it is important to begin the right treatment, as quickly as possible. Untreated epilepsy can increase your child’s risk of serious injury from seizures. Seizures can also put your child at social and academic disadvantage.

Once tests are complete, your doctor may prescribe:

Medication

Anti-epileptic drugs work to control seizures. While these medications cause side effects (e.g., drowsiness, fatigue, rashes), they help someone with epilepsy lead a normal life. For most children with cortical dysplasia, seizures are difficult to control with medication

Surgery

If seizures happen so often that they reduce a child’s quality of life, surgery may be necessary. Surgery can include removing the section of brain where seizures originate or implanting a small device that regulates electronic brain activity. The Epilepsy Center at Children’s Health’s epilepsy surgery program has a high rate of success, with our patient outcomes often exceeding those of other centers.

Diet

A ketogenic diet may be prescribed for your child which includes a regimen of high-fat, low-carbohydrate foods. 

FAQs

FAQs 

What causes cortical dysplasia?
Cortical dysplasia is a brain defect that is present at birth. This condition is one of the most common causes of epilepsy and seizures.

What are the symptoms of a seizure?
The epilepsy symptoms most people recognize are shaking (called convulsions) combined with the body getting rigid, clenching the jaw, and biting the tongue. These are called tonic-clonic seizures and many people still know them as grand mal seizures. But some seizures are barely noticeable. Children may stare into space, stop talking abruptly and then start talking again, or start repetitious movements like chewing their lips or moving a hand. These types of seizures are called absence seizures, which used to be known as petit mal seizures. Sometimes a child may experience smelling something that isn’t there, numbness or a tingling sensations before the seizure. These are called auras.

What should I do while my child is having a seizure?
If the seizure is small twitching or staring, they should come out of it easily. For convulsions, make sure your child is in a chair that they can’t fall out of or lying on the floor with a pillow under their head. Turn their head to the side, but NEVER try to put anything into their mouth. Do not shake or hit them or shout at them. If the seizure lasts for more than five minutes or seems violent, call 9-1-1.

After a seizure, your child may be confused, foggy or tired. If they want to lie down, let them.

What kind of tests are there for epilepsy?
Doctors first need to be sure that seizure aren’t due to something else before they diagnose epilepsy. Simple blood work and/or kidney tests might find that there is an infection causing seizures, and that might be cured easily. Otherwise there are a variety of brain-related tests, including an electroencephalogram (EEG), CT scan and MRI  that can show the electrical activity in the brain that indicates epilepsy.

Is epilepsy a sign of mental illness?
No, epilepsy is not a sign of mental or emotional illness. But a child with epilepsy can feel isolated, alone or depressed. That is why it is important to have a social worker or psychologist familiar with childhood epilepsy involved in treatment.

How is epilepsy treated?
There is no one specific treatment for any child with epilepsy. Each treatment plan is developed based on the child’s diagnosis and symptoms. For many children, medication can control seizures. Special diets can also help. If seizures happen so often that they reduce the child’s quality of life, surgery may be necessary. Surgery can include removing the section of brain where seizures originate or implanting a small device that regulates electronic brain activity.

What are the side effects of epilepsy treatment?
There can be side effects from treatment as well as from the disorder. Treatments can cause dizziness, fatigue and lead to balance problems. Seizure drugs can also cause bone density loss. Living with epilepsy can be stressful. A child may feel isolated, alone or depressed. Support groups and counseling can help.

Where can I find a support group?
Our Epilepsy Center will provide you with resources to help both you and your child. The Resources link on this webpage is also a good source for more information about epilepsy and support groups.

Can epilepsy be cured?
Sometime surgery can remove the section of the brain that is not working properly and can cure epilepsy. Sometimes children outgrow epilepsy; 74 out of 100 children become seizure-free within two years as long as there are no underlying problems. For those who don’t outgrow epilepsy, medication can eliminate and control seizures.

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