Limbic network co‐localization predicts pharmacoresistance in dysplasia‐related epilepsy

To evaluate the role of focal cortical dysplasia co‐localization to cortical functional networks in the development of pharmacoresistance. One hundred thirty‐six focal cortical dysplasia patients with 3.0 T or 1.5 T MRI were identified from clinical databases at Children's National Hospital. Clinico‐radio‐pathologic factors and network co‐localization were determined. Using binomial logistic regression, limbic network co‐localization (odds ratio 4.164 95% confidence interval 1.02–17.08, p = 0.048), and focal to bilateral tonic–clonic seizures (4.82, 1.30–18.03, p = 0.019) predicted pharmacoresistance. These findings provide clinicians with markers to identify patients with focal cortical dysplasia‐related epilepsy at high risk of developing pharmacoresistance and should facilitate earlier epilepsy surgical evaluation.