24-year preoperative evolution of a temporal astrocytoma

Pascual-Castroviejo, I; Blázquez, Martín G.; Molina, Manuel; Carceller, Fernando; Martín, V. López

doi:10.1007/bf00395099

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…Resection of the lesion, even when seizures are controlled by antiepileptic medication (14% in this series), permits the accurate diagnosis of a process that carries its own inherent risks. 28,65 In patients with nonproliferative lesions, which are well correlated with seizure characteristics and electrophysiological findings, the time that is lost while waiting to determine if the epilepsy is medically intractable may be tantamount to causing permanent neuropsychological impairment, as this report has clearly demonstrated. The longer the duration and the greater the seizure frequency, the higher the risk that the patient will incur neuropsychological impairment.…”

Section: Discussionmentioning

confidence: 69%

Surgery of epilepsy associated with focal lesions in childhood

Bourgeois¹,

Sainte‐Rose²,

Lellouch‐Tubiana³

et al. 1999

Journal of Neurosurgery

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Section: Discussionmentioning

confidence: 69%

Surgery of epilepsy associated with focal lesions in childhood

Bourgeois¹,

Sainte‐Rose²,

Lellouch‐Tubiana³

et al. 1999

Journal of Neurosurgery

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“…Resection of the lesion, even when seizures are controlled by antiepileptic medication (14% in this series), permits the accurate diagnosis of a process that carries its own inherent risks. [28,65] In patients with nonproliferative lesions, which are well correlated with seizure characteristics and electrophysiological findings, the time that is lost while waiting to determine if the epilepsy is medical intractable may be tantamount to causing permanent neuropsychological impairment, as this report has clearly demonstrated. The longer the duration and the greater the seizure frequency, the higher the risk that the patient will incur neuropsychological impairment.…”

Section: Discussionmentioning

confidence: 69%

Surgery in epilepsy associated with focal lesions in childhood

Bourgeois¹,

Sainte‐Rose²,

Lellouch‐Tubiana³

et al. 1999

FOC

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Surgery in children with epilepsy is a new, evolving field. The important practical issues have been to define strategies for choosing the most suitable candidates, as well as the type and the optimum timing of epilepsy surgery. This study was undertaken to illustrate these points. To identify the factors that correlated with outcome, the authors analyzed a series of 200 children (aged 1–15 years, mean 8.7 years) who underwent surgery at the Hôpital Necker-Enfants Malades between 1981 and 1996. In 171 cases (85.5%) the epilepsy was medically refractory and was associated with focal cortical lesions. Surgery consisted of resection of the lesion without specifically attempting to identify and remove the "epileptogenic area." In the group of children whose seizures were medically refractory, the mean follow-up period was 5.8 years. According to Engel's classification, 71.3% of these children became seizure free (Ia), whereas 82% were in Class I. A multivariate statistical analysis revealed that among all the factors studied, the success of surgery in a patient in whom there was a good clinical-electroencephalogram-imaging correlation, depended on the patients' having undergone a minimally traumatic operation, a complete resection of the lesion, and a short preoperative seizure duration. After the surgical control of epilepsy, behavior disorders were more improved (31% of all patients) than cognitive function (25%). The patient age at onset, duration and frequency of seizures, intractability of the disease to therapy, and seizure characteristics, were correlated with cognitive, behavioral, and academic performance pre- and postoperatively. Multivariate statistical analysis revealed that cognitive dysfunction correlated highly with the duration of epilepsy prior to surgery, whereas behavioral disorders correlated more with seizure frequency. These data must be taken into account when selecting patients for surgical treatment and when deciding the timing of surgery. Early surgical intervention allows for optimum brain development.

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“…Age at onset of seizures may be a determining factor with regard to the development of intellectual abilities. Pascual‐Castroviejo et al [16] reported severe psychomotor retardation in a patient suffering since 5 months of age from complex focal seizures that could not be controlled with medication. By contrast, Camfield et al [17] failed to identify any specific pattern of impairment characteristic of children with temporal lobe epilepsy when epilepsy began at school age.…”

Section: Neuropsychology Of Focal Epilepsiesmentioning

confidence: 99%

Neuropsychology of childhood epilepsy: Pre‐ and postsurgical assessment

Lassonde,

Sauerwein,

Jambaqué

et al. 2000

Epileptic Disorders

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Childhood epilepsy is one of the most prevalent forms of chronic and disabling childhood disorders. Because it disrupts brain maturation, it has long been thought to produce non‐specific consequences such as mental deficiency and behavioral problems. However, advances in medical knowledge have shown that childhood epilepsy should not be considered as a single disorder, and it is now becoming apparent that various clinical entities have different cognitive expressions that yet need to be specified. The purpose of this paper is to provide an up‐to‐date analysis of this multi‐faceted pathology. The first section is devoted to the characterization of the neuropsychological profile that accompanies focal epilepsies, as defined by the site of the epileptic process. We report the first group study of children with frontal lobe epilepsy. The results indicate that frontal lobe epilepsy produces symptoms (deficits of planning, attention and motor dexterity) that are akin to those found in frontal‐lesioned adults. Similarly, like in adults, temporal lobe epilepsy produces memory impairment in children as well as behavioral and academic disturbances. Occipito‐parietal lobe epilepsy is rare in children and its effects still need to be specified. The second section deals with the neuropsychological techniques used in presurgical evaluation. Finally, the various neurosurgical procedures that are increasingly being used as part of the arsenal of epilepsy treatment are described along with the neuropsychological findings that are associated with these interventions. It can be concluded that the beneficial effects of epilepsy surgery (callosotomy, hemispherectomy, temporal and extra‐temporal resections) by far outweigh the few cognitive deficits that are occasionally reported following these interventions.

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24-year preoperative evolution of a temporal astrocytoma

Cited by 5 publications

References 17 publications

Surgery of epilepsy associated with focal lesions in childhood

Surgery of epilepsy associated with focal lesions in childhood

Surgery in epilepsy associated with focal lesions in childhood

Neuropsychology of childhood epilepsy: Pre‐ and postsurgical assessment

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