Coexistent pathology in chronic epilepsy patients with neoplasms

Prayson, Richard A.; Fong, Joanna; Najm, Imad

doi:10.1038/modpathol.2010.94

Cited by 55 publications

(41 citation statements)

References 39 publications

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“…The specific role of each one of these pathological lesions in epileptogenesis is still not well defined. 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.…”

Section: Discussionsupporting

confidence: 82%

“…54,55,74,75,91 Our findings suggest that different pathological subtypes are associated with different postsurgery seizure outcomes. This implies that surgical failure, that is, seizure recurrence, may occur either because of incomplete resection of the epileptogenic zone or because of an underlying pathological condition with a worse outcome.…”

Section: Discussionmentioning

confidence: 76%

See 1 more Smart Citation

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: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 76%

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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“…Sporadic cases are more frequently encountered; they are usually solitary and affect younger patients [3]. The most common presenting symptoms are seizures and headache [4,5]. Herewith, we report on a case of meningioangiomatosis in a 5-year-old boy that presented with intractable seizures and without evidence of NF2 disease.…”

Section: Introductionmentioning

confidence: 99%

Meningioangiomatosis in a 5-Year-Old Boy Presenting with Intractable Seizures

Alexiou

Moschovi²,

Stefanaki³

et al. 2011

Pediatr Neurosurg

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A 5-year-old boy with a history of epilepsy underwent brain magnetic resonance imaging (MRI) because of an increase in seizure frequency. Brain MRI demonstrated a left frontal lesion. The patient was operated upon, and gross total excision was performed. The histological diagnosis was meningioangiomatosis. On follow-up examination 10 years later, the patient was free of seizures and without any evidence of tumor recurrence. Meningioangiomatosis is a rare benign hamartomatous lesion that is associated with seizures. Complete excision is associated with favorable long-term outcome. The novelty of the present case is the young age of the child at presentation and the curative role of surgery considering the long-term follow-up.

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“…Some authors mentioned that seizure attacks require dual pathology, as several observations revealed combinations of lesions (Jay et al, 1994;Oda et al, 1998;Juhsz et al, 1999;Li et al, 1999;Prayson et al, 2010); for example, the coexistence of brain tumors and cortical dysplasia, neuronal migration disorders and low grade gliomas, lesions having both neoplastic and malformed foci, extrahippocampal lesion plus hippocampal atrophy, and coexistence of hippocampal sclerosis and a potentially epileptogenic cortical lesion. It was also reported that bilateral hippocampal atrophy was found frequently in patients with temporal lobe developmental malformations, and that the presence of bilateral amygdala or amygdalo-hippocampal atrophy was associated with a higher risk of seizure recurrence (Kuzniescky et al, 1999).…”

Section: Combinations Of Lesions: "Dual Pathology"mentioning

confidence: 99%