Objective Discussed the postoperative seizure control situation of children with focal cortical dysplasia (FCD),which took Transmantle sign (T2WI or T2 FLAIR sequence inward extension cone high signal in the direction of ventricle) as the main MRI performance, and analyzed the influence of various factors on the prognosis of surgery.MethodsRetrospective analysis was performed on 56 children with FCD with Transmantle signs as the main MRI signs confirmed by pathology in Qilu Children's Hospital of Shandong University from May 2015 to March 2020, including 33 males and 23 females, with an average age of (4.8±0.13) years old, and their imaging and clinical data were analyzed. Analyzed the pathological types and main MRI signs, the range of epileptiform discharge, and Engel classification after surgery. Analyzed the effect of surgical method, type of onset, age of operation, epileptic site, course of disease and perioperative epileptic seizure on the surgical prognosis of children.ResultsPostoperative pathology showed that all the 56 cases both were FCDⅡb, in addition to the Transmantle sign, the MRI performance were also accompanied by focal blurring of gray and white matter, abnormal cortical structure, and abnormal signal foci in gray and white matter. Intraoperative EEG monitoring results showed that the epileptiform discharge area in all cases was larger than the lesion range showed by MRI. Postoperative Engel classification: 25 cases of gradeⅠ (43.8%), 18 cases of gradeⅡ (31.3%), 4 case of gradeⅢ (6.3%), 9 cases of gradeⅣ (18.8%). Surgical resection and perioperative seizures are independent factors affecting the prognosis of children (P<0.05).Conclusionsurgical methods and perioperative seizures were closely related to the prognosis of children.