Surgical management of temporal lobe tumor—related epilepsy in children

Cataltepe, Oguz; Turanlı, Güzide; Yalnızoğlu, Dilek; Topçu, Meral; Akalan, Nejat

doi:10.3171/ped.2005.102.3.0280

Cited by 51 publications

(61 citation statements)

References 31 publications

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“…5,14,22,25,43,44,58,59,69,75 Finally, in our series we found ELGT associated with MTS in 2 cases (10%), in agreement with previous data that reported this association in 2%-25% of cases. 14,16,86,98 In the setting of ELGT, the distinction among the various subtypes of tumors is essential for predicting the seizure outcome and the oncological behavior. In fact, gangliogliomas and dysembryoplastic neuroepithelial tumors may have pronounced intrinsic epileptogenic properties due to their neuronal and glial components, 14,21,23,[25][26][27] and their complete removal may lead to seizure freedom.…”

Section: Discussionmentioning

confidence: 99%

Seizure outcome in surgically treated drug-resistant mesial temporal lobe epilepsy based on the recent histopathological classifications

Giulioni¹,

Marucci

Martinoni³

et al. 2013

JNS

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D rug-resistant MTLE is the most common type of epilepsy requiring surgical treatment, with a favorable seizure outcome being achieved in about 60%-75% of patients. 50,51,64,82,89 Clinically, MTLE is often regarded as a relatively homogeneous syndromic entity, with seizures characterized by typical ictal semiology 32,96 and EEG findings. 29,96 However, a variety of MTLE subtypes have been described according to the underlying etiology, with different surgical prognoses. 47,89,92 Recent neuropathological classifications of epi lep to gen ic lesions, such as mesial temporal sclerosis (MTS), 11 granule cell pathology (GCP), 10 focal cortical dysplasia (FCD), 12 and epilepsy-associated low-grade tumor (ELGT) 1,54,55,73,74,91 Object. The study was performed to investigate the relation between seizure outcome after surgical treatment of mesial temporal lobe epilepsy (MTLE) and pathological findings, classified according to the recently proposed classifications of mesial temporal sclerosis (MTS), granule cell pathology (GCP), focal cortical dysplasia (FCD) and epilepsy-associated low-grade tumors (ELGT).Methods. The authors analyzed data obtained in 120 consecutive cases involving patients presenting with drugresistant MTLE, who underwent tailored anteromesial temporal lobe resection, and correlated seizure outcome with pathological findings. They identified 5 histopathological groups: Group 1-ELGT, alone or associated with other lesions (30 cases); Group 2-isolated FCD (17 cases); Group 3-MTS, with or without GCP (28 cases); Group 4-MTS associated with FCD, with or without GCP (37 cases); Group 5-other lesions (8 cases).Results. Engel Class I outcome was observed in 83% of patients with ELGT (Class IA in 63%); in 59% of patients with isolated FCD, with FCD Type II showing a better prognosis than FCD Type I; in 82% of patients with isolated MTS (Class IA in 50%), with MTS Type 1a and MTS Type 1b showing a better prognosis than MTS Type 2 and patients with MTS and GCP having better postsurgical results than those with MTS without GCP. Engel Class I outcome was also achieved in 84% of patients with FCD associated with MTS (Engel Class IA in 62%); also in this group MTS 1a and MTS 1b associated with FCD showed a better prognosis than FCD associated with MTS 2. Finally, Engel Class I was also achieved in 2 patients with vascular malformation and in 1 with a temporal pole encephalocele.Conclusions. Patients with MTLE and ELGT, MTS, or MTS associated with FCD showed the best postsurgical seizure outcome (Engel Class I in more than 80% of cases), whereas only 63% of patients with isolated FCD achieved the same type of outcome. Interestingly, the analysis of seizure outcome in histopathological subtypes of FCD and of MTS showed different prognoses in the different pathological subgroups, with worse outcomes for atypical MTS, absence of GCP, and isolated FCD Type I. 37Abbreviations used in this paper: EEG = electroencephalographic; ELGT = epilepsy-associated low-grade tumor; FCD = focal cortical dysplasia; GCP = granule cell ...

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Section: Discussionmentioning

confidence: 99%

Seizure outcome in surgically treated drug-resistant mesial temporal lobe epilepsy based on the recent histopathological classifications

Giulioni¹,

Marucci

Martinoni³

et al. 2013

JNS

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“…The performance of amygdalohippocampectomy was limited to a nondominant hemisphere or to dual pathologic entities in a dominant hemisphere. 16 Our strategy was similar to this, with the difference that we applied a more tailored lesionectomy to mesial temporal lobe tumors. Approximately 70% of our patients who received a tailored lesionectomy for an amygdala or a parahippocampal gyrus tumor had a good seizure outcome; however, 2 patients required removal of the hippocampus after tailored lesionectomy, and MTS was found in 1 of the patients.…”

Section: Surgical Strategymentioning

confidence: 99%

Long‐term surgical outcomes of temporal lobe epilepsy associated with low‐grade brain tumors

Phi

Kim

Cho

et al. 2009

Cancer

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“…Rezektif cerrahi ile lezyonlu ve lezyonsuz vakalarda epileptojenik zonun saptanması, fonksiyonel kayıp yaratmadan çıkarılabilecek bölgenin sınırlarının belirlenmesi ve buna uygun cerrahi yöntemin uygulanması amaçlanır. [40,41] Çocukluk çağında unilateral hemisferik lezyonu olan vakalarda (perinatal infarkt, post enfeksiyoz/post travmatik hemisferik lezyonlar, hemimegalensefali gibi gelişimsel bozukluklar, Rasmussen ensefaliti, Sturge-Weber sendromu) bir hemisfere yönelik cerrahi uygulanabilir. Anatomik hemisferektomi komplikasyonları nedeniyle son yıllarda yerini hemisferotomi ve fonksiyonel hemisferektomi tekniklerine bırakmıştır.…”

Section: İnvazif Incelemeler İntrakranyal Kayıtlarunclassified

Intractable Epilepsy in Childhood: Presurgical Evaluation and Treatment

Yalnızoğlu¹

2016

Epilepsi

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ÖzetÇocukluk çağı epilepsilerinde erken tedavi ile nöbet kontrolünün sağlanması, tekrarlayan nöbetlere bağlı nöronal hasarın engellenmesi, normal gelişimin yakalanması, ilaç yan etkilerinin en aza indirilmesi ve hayat kalitesinin artırılması açısından büyük önem taşır. Dirençli epilepsinin tedavi seçenekleri arasında epilepsi cerrahisi son yıllarda giderek artan bir ağırlık kazanmıştır. Ekstratemporal epilepsilerin oranının daha fazla olması, etyolojide gelişimsel lezyonların öne çıkması nedeniyle pediatrik epilepsi popülasyonu erişkin yaş grubuna oranla daha refrakter bir profil çizer. Bununla birlikte epilepsi cerrahisi sonuçlarının nöbet kontrolü açısından erişkin ve çocuk yaş grubunda benzer sonuçlar verdiği gösterilmiştir; yetişkinlerde olduğu gibi süt çocuğu yaş grubu dahil çocukluk çağında da başarıyla uygulanabilmektedir. Bu yazıda çocukluk çağı epilepsilerinde epilepsi cerrahisi uygulamaları tartışılacaktır.Anahtar sözcükler: Çocuklar; dirençli; epilepsi; epilepsi cerrahisi. SummaryIn childhood, early treatment and management of seizures are essential to prevent neuronal injury owing to intractable seizures, as well as achieving normal development, minimizing the adverse effects of antiepileptic drugs, and improving quality of life. Epilepsy surgery has become an important option in the treatment of intractable epilepsy. Children with intractable epilepsy have a more refractory profile compared to adults due to the higher rates of extratemporal epilepsies and develeopmental lesions as the underlying etiology. However, both adults and children have similar outcome following epilepsy surgery, and surgical treatment is efficiently applied in pediatric patients including infants. This paper reviews presurgical evaluation in children with intractable epilepsy and summarizes treatment modalities.

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Surgical management of temporal lobe tumor—related epilepsy in children

Cited by 51 publications

References 31 publications

Seizure outcome in surgically treated drug-resistant mesial temporal lobe epilepsy based on the recent histopathological classifications

Seizure outcome in surgically treated drug-resistant mesial temporal lobe epilepsy based on the recent histopathological classifications

Long‐term surgical outcomes of temporal lobe epilepsy associated with low‐grade brain tumors

Intractable Epilepsy in Childhood: Presurgical Evaluation and Treatment

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