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Question Date: 05/11/2023

Question: The commonest pathological substrate in surgical series of refractory epilepsy in children is..

Options:

• Hippocampal Sclerosis
• Gliosis
• Low grade tumors
• Focal cortical dysplasia

Correct Answer: Focal cortical dysplasia

Explaination: Refractory epilepsy disabling seizures despite appropriate trial of two antiepileptic drugs either in combination or alone<br>FCD is the commonest cause for DRE in children over all and in surgical series<br>In developing countries like India the etiology differs from western literature, Adverse peri-natal events (48%) and CNS infection sequalae (24%) were major causes (Chawla et al)<br>Hippocampal sclerosis is commonest etiology in adults with refractory epilepsy undergoing surgery

Reference: J. Engel Ann Indian Acad Neurol.2014 Mar17Indian J Pediatr Oct 2014, 81(10)