{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T15:04:56Z","timestamp":1783955096791,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Polymicrogyria (PMG) presents a complex challenge in epilepsy surgery. The optimal surgical strategy and extent of resection, from hemispheric to more limited approaches, remain debated. We aimed to summarize subject\u2010level surgical outcomes and identify factors informing procedure selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a subject\u2010level pooled analysis of 161 patients across 20 retrospective studies, evaluating surgical outcomes (Engel classification), in relation to anatomic extent, surgical procedure, use of intracranial electroencephalography (ICEEG), and other decision\u2010influencing factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At \u226512\u2009months follow\u2010up, ~70% of patients achieved seizure freedom (Engel Class I). In our univariate analysis Engel Class I outcomes were associated with shorter epilepsy duration (8.05 vs 11.92\u2009years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Hemispheric PMG was linked to earlier seizure onset (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and a higher incidence of\n                      <jats:italic>epileptic encephalopathy with spike\u2013wave activation in sleep<\/jats:italic>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0005). Among unilateral non\u2010hemispheric and bilateral PMG cases, seizure\u2010freedom rates were similar between hemispheric and more limited resections, but the latter were associated with a lower incidence of new or worsened motor deficits. Mixed\u2010effects logistic regression (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009160) showed that hemispheric surgery increased the odds of seizure freedom but without statistical significance (odds ratio [OR]\u2009=\u20093.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.055). ICEEG did not significantly influence seizure outcomes but may play a key role in identifying eloquent cortex and guiding safer, tailored resections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In PMG\u2010related epilepsy, surgical strategy must balance seizure control with preservation of function. ICEEG (especially stereo\u2010EEG [SEEG]) remains a valuable tool for functional mapping and tailored resections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70204","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:30:52Z","timestamp":1773934252000},"page":"3304-3317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical treatment of epilepsy in polymicrogyria: A subject\u2010level meta\u2010analysis and decision\u2010making framework"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5375-5197","authenticated-orcid":false,"given":"Luca","family":"Bosisio","sequence":"first","affiliation":[{"name":"Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Full Member of ERN EpiCARE  Genoa Italy"},{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI) University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2722-7756","authenticated-orcid":false,"given":"Carolina","family":"Viglietti","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI) University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4354-6906","authenticated-orcid":false,"given":"Alessandro","family":"Consales","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI) University of Genoa  Genoa Italy"},{"name":"Pediatric Neurosurgery Unit IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9957-7760","authenticated-orcid":false,"given":"Giulia","family":"Nobile","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Full Member of ERN EpiCARE  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6426-6164","authenticated-orcid":false,"given":"Mattia","family":"Pacetti","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery Unit IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5621-4046","authenticated-orcid":false,"given":"Domenico","family":"Tortora","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit IRCCS Istituto Giannina Gaslini  Genoa 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0577-5193","authenticated-orcid":false,"given":"Stefano","family":"Francione","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Full Member of ERN EpiCARE  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.4.715"},{"issue":"5","key":"e_1_2_13_3_1","first-page":"788","article-title":"The changing MR imaging appearance of polymicrogyria: a consequence of myelination","volume":"24","author":"Takanashi J","year":"2003","journal-title":"Am J 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A study of 12 children with unilateral polymicrogyria associated with epilepsy with CSWS treated by hemispherotomy","volume":"21","author":"Jalin C","year":"2009","journal-title":"Epilepsies"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14556"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.01095"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-018-3775-0"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16092"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebcr.2016.01.005"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2012.03667.x"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2021.01.010"},{"key":"e_1_2_13_36_1","article-title":"Network radiofrequency ablation for drug\u2010resistant epilepsy","volume":"16","author":"Shamim D","year":"2021","journal-title":"Epilepsy Behav Rep"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13264"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12988"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh224"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2022.100542"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02487.x"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70204","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi.70204","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T14:14:41Z","timestamp":1783952081000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi.70204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/epi.70204"],"URL":"https:\/\/doi.org\/10.1002\/epi.70204","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]},"assertion":[{"value":"2025-09-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}