  Focal cortical dysplasias (FCDs) are the most common cause of treatment
resistant epilepsy affecting the pediatric population. Most individuals with
FCD have seizure onset during the first five years of life and the majority
will have seizures by the age of sixteen. Many cases of FCD are postulated to
be the result of abnormal brain development in utero by germline or somatic
gene mutations regulating neuronal growth and migration during corticogenesis.
Other cases of FCD are thought to be related to infections during brain
development, or even other causes still unable to be fully determined. Typical
anti-seizure medications are oftentimes ineffective in FCD as well as surgery
is unable to be successfully performed due to the involvement of eloquent areas
of the brain or insufficient resection of the epileptogenic focus, posing a
challenge for physicians. The genetic nature of FCD provides an avenue for drug
development with several genetic and molecular targets undergoing study over
the last two decades.
