{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:24:27Z","timestamp":1774326267147,"version":"3.50.1"},"reference-count":49,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T00:00:00Z","timestamp":1503446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["#8147328"],"award-info":[{"award-number":["#8147328"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004963","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["# 602531"],"award-info":[{"award-number":["# 602531"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In 2011, the International League Against Epilepsy (<jats:styled-content style=\"fixed-case\">ILAE<\/jats:styled-content>) proposed a consensus classification system of focal cortical dysplasia (<jats:styled-content style=\"fixed-case\">FCD<\/jats:styled-content>) to distinguish clinicopathological subtypes, for example, \u201cisolated\u201d<jats:styled-content style=\"fixed-case\">FCD<\/jats:styled-content>type Ia\u2013c and<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>a\u2013b, versus \u201cassociated\u201d<jats:styled-content style=\"fixed-case\">FCD<\/jats:styled-content>type<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>a\u2013d. The histopathological differentiation of<jats:styled-content style=\"fixed-case\">FCD<\/jats:styled-content>type I and<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>variants remains, however, a challenging issue in everyday practice. We present a unique histopathological pattern in patients with difficult\u2010to\u2010diagnose<jats:styled-content style=\"fixed-case\">FCD<\/jats:styled-content>, which highlights this dilemma, but also helps to refine the current<jats:styled-content style=\"fixed-case\">ILAE<\/jats:styled-content>classification scheme of<jats:styled-content style=\"fixed-case\">FCD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We present a retrospective series of 11 male and one female patient with early onset pharmacoresistant epilepsy of the posterior quadrant (mean age at seizure onset = 4.6 years). All surgical specimens were reviewed. Clinical histories were retrieved and extracted from archival patient files.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Microscopic inspection revealed abnormalities in cortical architecture with complete loss of layer 4 in all surgical samples of the occipital lobe, as confirmed by semiquantitative measurements (p &lt; 0.01). Clinical history reported early transient hypoxic condition in nine patients (75%). Magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) revealed abnormal signals in the occipital lobe in all patients, and signal changes suggestive of subcortical encephalomalacia were found in seven patients. Surgical treatment achieved favorable seizure control (Engel class I and<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>) in seven patients with an available follow\u2010up period of 6.1 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Prominent disorganization of cortical layering and lack of any other microscopically visible principle lesion in the surgical specimen would result in this neuropathological pattern hitherto being classified as<jats:styled-content style=\"fixed-case\">FCD ILAE<\/jats:styled-content>type Ib. However, perinatal hypoxia with distinctive<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>changes suggested primarily a hypoxemic lesion and acquired pathomechanism of neuronal cell loss in the occipital lobe of our patient series. We propose, therefore, classifying this distinctive clinicopathological pattern as a separate variant of<jats:styled-content style=\"fixed-case\">FCD ILAE<\/jats:styled-content>type<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>d.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.13855","type":"journal-article","created":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T11:58:51Z","timestamp":1503489531000},"page":"1697-1705","source":"Crossref","is-referenced-by-count":16,"title":["A distinct clinicopathological variant of focal cortical dysplasia<scp>III<\/scp>d characterized by loss of layer 4 in the occipital lobe in 12 children with remote hypoxic\u2013ischemic injury"],"prefix":"10.1111","volume":"58","author":[{"given":"Dan\u2010Dan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pathology Xuanwu Hospital Capital Medical University Beijing 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