April 22, 2021

What do you know about focal cortical dysplasia?

About Epilepsy

Focal cortical dysplasia is a common type of epilepsy. Find out what it is, how it’s diagnosed and the treatment options available.

While you are in the womb, your brain is constantly growing and developing. Sometimes the cells in your brain get disorganized during this process. In some people this can lead to focal cortical dysplasia - which is a common type of epilepsy.

Focal cortical dysplasia is known as one of hardest epilepsies to treat with medication. However, alternative treatments are often very successful.

Here’s everything you need to know about focal cortical dysplasia symptoms and treatment.

Patient talking to doctor about focal cortical dysplasia

What is focal cortical dysplasia?

Focal cortical dysplasia is a type of epilepsy that is caused by unusual cell formation at certain points on the brain:

  • Focal: This means that the seizures are always triggered by electrical activity that starts at one specific place on the brain.
  • Cortical: This means that the activity begins on the cortex, which is the outer layer of the brain.
  • Dysplasia: This is when unusual cells are found in the tissues of an organ.

These unusual patterns of cell growth can be a trigger for epileptic seizures.

Focal cortical dysplasia symptoms

Depending on where the dysplasia is on your brain, you may experience different kinds of seizures and symptoms. That said, it is most common to experience tonic clonic seizures (which is when you fall over and shake) or absence seizures (which is where you stare into space and may make repetitive movements).

Focal cortical dysplasia symptoms appear in the first five years of life for about two thirds of people - and most of the rest will have started having seizures by the time they turn 16. Initial onset of focal cortical dysplasia in adults is much rarer.

How is focal cortical dysplasia diagnosed?

This kind of epilepsy can sometimes be challenging to diagnose. For example, a focal cortical dysplasia MRI scan may not always be able to identify the cells which are causing the seizures.

But doctors have a number of methods for diagnosing focal cortical dysplasia. These include:

  • EEG’s: An EEG is a device worn on the head that measures electrical activity in your brain
  • Modern MRI: The most advanced neuroimaging techniques can help to identify some types of focal cortical dysplasia
  • Medical history: A detailed history of when you began having seizures the types of seizures you had, you can keep a diary of your condition with apps such as Epsy
  • Other symptoms of a dysplasia: Including language learning delays and visual problems

How is focal cortical dysplasia treated?

Focal cortical dysplasia is one of the types of epilepsy which is least responsive to treatment by medication. This is called refractory epilepsy. Around 4 in 5 people with focal cortical dysplasia find that drugs do not control their seizures (compared to one in three among other people with epilepsy).

Learn more: What is drug-resistant epilepsy?

If you have tried two or more types of anti-epilepsy drug to treat focal cortical dysplasia but your seizures have not stopped permanently, it may mean that you have refractory epilepsy.

The good news is that there are alternative treatments which are very successful:

  • Surgery: Studies have shown that removing the part of the brain which is causing the seizures can lead to seizure freedom for as much as 67% of people.
  • Antiseizure devices: Sometimes surgery is not possible because it would risk damaging vital parts of the brain. Medical device implants can provide an alternative way of controlling seizures and reducing their severity.

Living a full life with focal cortical dysplasia

Although living with focal cortical dysplasia can be challenging, getting it diagnosed early and exploring treatment options means you might be able to gain greater control over your seizures. 

Take Jared Muscat for example – a surfer and digital marketing professional for Patagonia who has focal cortical dysplasia. Read about  his experience here