Glioneuronal tumors and medically intractable epilepsy: a clinical study with long-term follow-up of seizure outcome after surgery

Aronica, Eleonora; Leenstra, Sieger; Veelen, C.W.M. van; Rijen, Peter C. van; Hulsebos, Theo J.M.; Tersmette, A. C.; Yankaya, Bulent; Troost, Dirk

doi:10.1016/s0920-1211(00)00208-4

Cited by 166 publications

(180 citation statements)

References 49 publications

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“…According to the WHO classification [8], GG with anaplastic glial features are considered WHO grade III. Early surgical resection of GG reduces long-term morbidity and mortality from seizures, making surgery the treatment of choice [9][10][11]. Gross total resection is recommended, even if significant reduction of symptoms, including freedom from seizures, can be often achieved with partial resection.…”

Section: Clinical and Neuropathologic Featuresmentioning

confidence: 99%

“…DNT are slowly growing WHO grade I tumors with a chance of malignant transformation of <1 % [8]. Similarly to GG, early surgical gross total resection represents the treatment of choice [9,[15][16][17][18]. Whether the presence of associated cortical dysplasia may influence the seizure outcome is still unclear [19,20].…”

Section: Clinical and Neuropathologic Featuresmentioning

confidence: 99%

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Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Aronica

Crino

2014

Neurotherapeutics

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Section: Clinical and Neuropathologic Featuresmentioning

confidence: 99%

Section: Clinical and Neuropathologic Featuresmentioning

confidence: 99%

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Aronica

Crino

2014

Neurotherapeutics

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“…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).…”

mentioning

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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“…При поздней диагностике опухоли в некоторых случаях про-цесс может тотально поражать одно полушарие с вовлече-нием контралатерального [5,6]. Надо заметить, что ин-фильтративный рост может приводить к распростране-нию процесса за пределы видимых изменений на МРТ, что затрудняет определение четких границ опухолевого процесса при резекции [4,15]. Сигнальные характеристи-ки ДА в типичных случаях представлены гиперинтенсив-ным достаточно однородным МР-сигналом на Т2-и FLAIR-ВИ и гипо-или изоинтенсивным сигналом на Т1-ВИ [3,6,7].…”

Section: Discussionunclassified

“…Сигнальные характеристи-ки ДА в типичных случаях представлены гиперинтенсив-ным достаточно однородным МР-сигналом на Т2-и FLAIR-ВИ и гипо-или изоинтенсивным сигналом на Т1-ВИ [3,6,7]. Высокий потенциал ДА в возникновении эпилепсии отмечен в ряде международных исследований [1,4,6,15].…”

Section: Discussionunclassified

MRI-characteristics of epileptogenic supratentorial brain tumors in children

Khalilov¹,

Холин²,

Medvedeva³

et al. 2016

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Цель исследования -анализ результатов магнитно-резонансной томографии (МРТ) у пациентов с симптоматической эпилепсией, ассоциированной с опухолью. Материал и методы. Были проанализированы данные МРТ 52 пациентов с симптоматической эпилепсией, проходивших лечение по поводу опухолей супратенториальной локализации. Были выявлены наиболее эпилептогенные опухоли. Особое внимание было уделено опухолям со стертой клинической картиной и не имевшим типичных МРТ-признаков. Все пациенты с опухолями были прооперированы с применением различных методик хирургического вмешательства. Результаты. Наиболее эпилептогенными опухолями оказались дизэмбриопластические нейроэпителиальные опухоли (ДНЭО), диффузные астроцитомы (ДА) и ганглиоглиомы (ГГ). Во всех случаях ДНЭО и у 4 пациентов с ГГ эпилептические приступы являлись дебютным, а в 4 из 5 случаев ДНЭО -единственным клиническим признаком наличия опухоли. При МРТ в случаях ДНЭО, ДА и ГГ выявлялись изо/ гипоинтенсивный сигнал на Т1-ВИ и варьирующий по интенсивности от умеренного до гиперинтенсивного сигнала на Т2-и FLAIR-ВИ, при этом в случаях с ДНЭО и ГГ практически отсутствовали масс-эффект и перифокальный отек, а на FLAIR-ВИ наиболее четко прослеживалась так называемая пеноподобная (мультикистозная) структура. Не отмечено существенного изменения размеров ДНЭО и ГГ. В 1 случае отмечено сочетание ДНЭО с корковой дисплазией. При ДА трудно отличить перифокальный отек от туморозной ткани и неизмененных тканей головного мозга, и, как правило, рост опухоли замедлен. Заключение. Эпилептогенные опухоли могут копировать рентгенологические характеристики друг друга, а также мимикрировать ганглиоглиомы, олигодендроглиомы и астроцитомы Gr I, II и др. Они являются наиболее частыми причинами возникновения симптоматической фокальной эпилепсии. Эти образования необходимо в первую очередь исключать в случаях фармакорезистентной эпилепсии. Ключевые слова: опухоли головного мозга у детей, симптоматическая фокальная эпилепсия, эпилептическая хирургия, нейровизуализация.Objective -to analyze MR-images in patients with symptomatic epilepsy associated with the brain tumor. Material and methods. MRI results of 52 patients with symptomatic epilepsy operated for tumors of supratentorial localization were analyzed. The most epileptogenic tumors with atypical MRI signs and subtle clinical presentation were identified. All patients with tumors were operated using different methods of surgical intervention. Results. Dysembryoplastic neuroepithelial tumors (DNET), diffuse astrocytomas (DA) and gangliogliomas (GG) were the most frequent epileptogenic tumors. In all the cases of DNET and in 4 patients with GG, epileptic seizures were the first, and in 4 of 5 cases of DIO were the only clinical sign of tumor presence. In DNET, DA and GG, there was an iso-or hypointensive signal on T1 WI and a signal varying in intensity from moderate to hyperintense in T2 and FLAIR WI, while in cases with DNET and GG, no mass effect and perifocal edema was practically seen. The so-called «spume-like» (multicystic) structure was m...

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Glioneuronal tumors and medically intractable epilepsy: a clinical study with long-term follow-up of seizure outcome after surgery

Cited by 166 publications

References 49 publications

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

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

MRI-characteristics of epileptogenic supratentorial brain tumors in children

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