Recovery from Autism after Successful Surgery for a Benign Brain Tumor Associated with Epilepsy

Hrdlička, Michal; Kudr, Martin; Kršek, Pavel; Tichý, Michal; Kynčl, Martin; Zámečnı́k, Josef; Mohaplová, Markéta; Dudová, Iva

doi:10.1007/s10803-019-03935-z

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…Beyond driving behavioral symptoms, epileptogenic lesions may be associated with psychiatric disease; however, this relationship is understudied and sporadically reported in the literature. Only a few case reports have described ASD associated with epileptogenic tumors, specifically in the cerebellum [25,26] and mesial temporal lobe [27][28][29]. Two of the cases with temporal tumors saw major improvements in ASD symptoms [27,28], and the last case demonstrated full clinical recovery from ASD, after surgery [29].…”

Section: Discussionmentioning

confidence: 99%

“…Only a few case reports have described ASD associated with epileptogenic tumors, specifically in the cerebellum [25,26] and mesial temporal lobe [27][28][29]. Two of the cases with temporal tumors saw major improvements in ASD symptoms [27,28], and the last case demonstrated full clinical recovery from ASD, after surgery [29]. The latter patient was a 3-year-old boy who had ASD and developed a mesial temporal lobe ganglioglioma with seizures [29].…”

Section: Discussionmentioning

confidence: 99%

“…Two of the cases with temporal tumors saw major improvements in ASD symptoms [27, 28], and the last case demonstrated full clinical recovery from ASD, after surgery [29]. The latter patient was a 3-year-old boy who had ASD and developed a mesial temporal lobe ganglioglioma with seizures [29]. After resection and complete seizure freedom, psychology follow-up showed increased sociability, decreased hyperactivity and aggression, improved eye contact, and decreased stereotyped behavior.…”

Section: Discussionmentioning

confidence: 99%

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Behavioral Improvements following Lesion Resection for Pediatric Epilepsy: Pediatric Psychosurgery?

et al. 2023

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Introduction: Resection of brain lesions associated with refractory epilepsy to achieve seizure control is well-accepted. However, concurrent behavioral effects of these lesions such as changes in mood, personality, and cognition and the effects of surgery on behavior have not been well characterized. We describe 5 such children with epileptogenic lesions and significant behavioral abnormalities which improved after surgery. Case Descriptions: Five children (ages 3-14 years) with major behavioral abnormalities and lesional epilepsy were identified and treated at our center. Behavioral problems included academic impairment, impulsivity, self-injurious behavior, and decreased social interaction with diagnoses of ADHD, oppositional defiant disorder, and autism. Pre-operative neuropsychiatric testing was performed in 4/5 patients and revealed low-average cognitive and intellectual abilities for their age, attentional difficulties, and poor memory. Lesions were located in the temporal (2 gangliogliomas, 1 JPA, 1 cavernoma) and parietal (1 DNET) lobes. Gross total resection was achieved in all cases. At mean 1-year follow-up, seizure freedom (Engel 1a in 3 patients, Engel 1c in 2 patients) and significant behavioral improvements (academic performance, attention, socialization, and aggression) were achieved in all. Two patients manifested violence pre-operatively; one had extreme behavior with violence towards teachers and peers despite low seizure burden. Since surgery, his behavior has normalized. Conclusion: We identified five patients with severe behavioral disorders in the setting of lesional epilepsy, all of whom demonstrated improvement after surgery. The degree of behavioral abnormality was disproportionate to epilepsy severity, suggesting a more complicated mechanism by which lesional epilepsy impacts behavior. We propose a novel paradigm in which lesionectomy may offer behavioral benefit even when seizures are not refractory. Thus, behavioral improvement may be an important novel goal for neurosurgical resection in children with epileptic brain lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Behavioral Improvements following Lesion Resection for Pediatric Epilepsy: Pediatric Psychosurgery?

et al. 2023

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Cerebellar impairments in genetic models of autism spectrum disorders: A neurobiological perspective

Yenkoyan,

Grigoryan,

Kutna

et al. 2024

Progress in Neurobiology

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Autistic patient in a (paediatric) neurologist's practice

Zumrová¹

2022

Neurol. pro Praxi

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Klinika dětské neurologie 2. LF UK a FN Motol, Praha Centrum hereditárních ataxií FN Motol -člen ERN-RND, Praha Poruchy autistického spektra (PAS) se projevují v oblasti sociálních interakcí, komunikace a chování. Diagnózu autismu má stanovit za použití specializovaného psychologicko-psychiatrického vyšetření, které zahrnuje minimálně dvě standardizované metody, pouze erudovaný psycholog nebo psychiatr, který se touto problematikou dlouhodobě zabývá. Každý pacient s PAS by však měl být komplexně vyšetřen, aby byla zjištěna buď etiologie obtíží, nebo komorbidita skrytá pod obrazem autistických projevů. Rozmanitost diagnóz, které mohou být příčinou autistických projevů pacienta, dokumentují tři diametrálně rozdílné kazuistiky z praxe.Klíčová slova: autismus, diferenciální diagnostika autismu, komorbidity autismu. Autistic patient in a (paediatric) neurologist's practiceAutism spectrum disorders (ASDs) are manifested in the area of social interactions, communication, and behaviour. The diagnosis of autism is to be made by an experienced psychologist or psychiatrist who has had long expertise in this field, using a specialized psychological-psychiatric testing which involves at least two standardized methods. However, every ASD patient should undergo comprehensive evaluation in order to ascertain either the aetiology of the symptoms or the comorbidity obscured by autistic symptomatology. The diverse diagnoses that can cause autistic symptoms in a patient are documented by three entirely different case reports from the practice. ses that can cause autistic symptoms in a patient are documented by three entirely different case reports from the practice.

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Recovery from Autism after Successful Surgery for a Benign Brain Tumor Associated with Epilepsy

Cited by 5 publications

References 19 publications

Behavioral Improvements following Lesion Resection for Pediatric Epilepsy: Pediatric Psychosurgery?

Behavioral Improvements following Lesion Resection for Pediatric Epilepsy: Pediatric Psychosurgery?

Cerebellar impairments in genetic models of autism spectrum disorders: A neurobiological perspective

Autistic patient in a (paediatric) neurologist's practice

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