Relief of Seizures from a Predominantly Posterior Temporal Tumor with Anterior Temporal Lobectomy

Sperling, Michael R.; Cahan, Leslie D.; Brown, W. J.

doi:10.1111/j.1528-1157.1989.tb05471.x

Cited by 39 publications

(16 citation statements)

References 10 publications

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“…Noninvasive recording and careful mapping show that a structural lesion is not the source of epileptic activity (12)(13)(14). Some studies about lesional epilepsies showed lateralization of epileptogenic foci to distant ipsilateral (15,16) or even to contralateral regions (17). However, few studies have addressed a clear correlation between the lesion site and epileptogenic foci of the ictal onset zone as well as the irritative zone.…”

Section: Introductionmentioning

confidence: 99%

Epileptogenic Foci on Subdural Recording in Intractable Epilepsy Patients with Temporal Dysembryoplastic Neuroepithelial Tumor

Seo

Hong

2003

J Korean Med Sci

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To investigate the epileptogenic foci in dysembryoplastic neuroepithelial tumor (DNT) in the temporal lobe, we studied extraoperative electrocorticography (ECoG) with subdural electrode arrays from nine patients with intractable epilepsy due to temporal DNT. Ictal onset zones and irritative zones were decided by the ECoG. The locations of these zones were compared to the location of the tumor. The number of ictal onset zone and irritative zone was 2.1+/-0.93 and 2.9+/-1.45 in a patient with a DNT. They were detected more frequently in the adjacent tissues of the tumor (88.9%) rather than within the tumor or in mesial temporal area (66.7%). Mesial temporal involvement was found in 6 patients (66.7%) as an ictal onset zone, and in 5 (55.6%) as an irritative zone. The 7 patients (77.8%) had ictal onset zone in areas different from active irritative zone. The surgical outcome was better, when ictal onset zone was completely resected rather than partially removed. Temporal DNT can make multiple ictal onset zones and irritative zones in different regions including the mesial temporal area. Deliberate resection of epileptogenic foci, including all ictal onset zones and irritative zones, ensures excellent seizure control.

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Section: Introductionmentioning

confidence: 99%

Epileptogenic Foci on Subdural Recording in Intractable Epilepsy Patients with Temporal Dysembryoplastic Neuroepithelial Tumor

Seo

Hong

2003

J Korean Med Sci

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“…Clear guidelines of surgery for LTLE were absent, and seizure reduction or cure by anterior temporal lobectomy in remote posterior lesion was reported in several studies 9,10. We included the anterior temporal area because of the rapid propagation of ictal rhythms from the posterior to anterior temporal area.…”

Section: Discussionmentioning

confidence: 99%

Clinico-electrical Characteristics of Lateral Temporal Lobe Epilepsy; Anterior and Posterior Lateral Temporal Lobe Epilepsy

Lee

Yun

et al. 2006

J Clin Neurol

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Background and PurposeThis study aimed to determine whether there are clinicoelectrical differences between anterior lateral temporal lobe epilepsy (ALTLE) and posterior lateral temporal lobe epilepsy (PLTLE), taking medial temporal lobe epilepsy (MTLE) as a reference.MethodsWe analyzed the historical information, ictal semiologies, and ictal EEGs of temporal lobe epilepsy patients with a documented favorable surgical outcome (Engel class I or II) at follow-up after more than one year. LTLE was defined when a discrete lesion on MRI or an ictal onset zone in invasive study was located outside the collateral sulcus. LTLE was further divided into ALTLE and PLTLE by reference to the line across the cerebral peduncle. Total 107 seizures of 13 ALTLE, 8 PLTLE and 21 MTLE patients were reviewed.ResultsInitial hypomotor symptom was frequently observed in PLTLE (P<0.001). Oroalimentary automatism (OAA) was not observed initially in PLTLE. Generalized tonic-clonic seizures occurred significantly earlier in PLTLE than in ALTLE or MTLE (P< 0.001). Ictal scalp EEG was not helpful in differentiating between ALTLE and PLTLE.ConclusionsFrequent hypomotor onset, the absence of initial oroalimentary automatism, and early generalization are characteristic findings of PLTLE, although they are insufficient to differentiate it from ALTLE or MTLE.

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“…This tendency is seen from the fact that lesionectomy alone relieved seizures in 9 of 14 patients with extra temporal lesions, but in only 2 out of 9 patients with temporal lesions 6 . It is possible that secondary foci develop more often, and become autonomous more readily in the temporal lobes than in other areas of the brain 16 -42 - 45 . Whether GGs abet this process, or whether their association is merely a statistical illusion, needs to be looked into.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of refractory epilepsy associated with space occupying lesions experience and review

Brainer-Lima

Rao

Cukiert

et al. 1996

Arq. Neuro-Psiquiatr.

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-Surgery for space occupying lesions of the brain associated with intractable epilepsy represents a special problem because relief of the epilepsy is as much an operative goal as excision of the space occupying lesion itself. This study concerns 32 patients with space occupying lesions and intractable epilepsy who underwent excision of the lesion with acute intraoperative electrocorticography guided resection of the epileptogenic focus. Of the 32 patients, 16 formed a subgroup of gangliogliomas alone. The remaining were mixed lesions, predominantly benign. The duration of seizures in these patients ranged from 2 to 30 years, and the seizure frequency varied from 1 to 300 convulsions per month. The operative procedures included temporal corticectomy, amygdalo-hippocampectomy, and extratemporal corticectomies. Twenty nine patients were in Engel class I postoperatively, and three patients were in Engel class II. The findings with gangliogliomas are also considered in a separate group. This study strongly suggests that the operative procedure under electrocorticography guidance improves seizure outcome in space occuping lesions related intractable epilepsy.KEY WORDS: brain tumor, ganglioglioma, refractory epilepsy, electrocorticography.Tratamento cirúrgico da epilepsia refratária associada a lesões expansivas: experiência e revisão RESUMO -O tratamento cirúrgico das lesões que ocupam espaço (LOE) do sistema nervoso associadas a epilepsia intratável representa um problema clínico especial, já que tanto o tratamento da lesão como o da epilepsia são relevantes. Estudaram-se 32 pacientes com LOEs que foram submetidos a lesionectomia com margens guiadas por eletrocorticografia. Destes, 16 possuíam gangliogliomas e os restantes lesões variadas, predominantemente benignas. A duração das crises nesses pacientes variou de 2 a 30 anos e a frequência das crises de 1 a 300 por mês. Os procedimentos cirúrgicos incluíram corticectomia temporal, amigdalo-¬ hipocampectomia e corticectomias extra-temorais. Vinte e nove pacientes estvam em grau I de Engel pós-¬ operatoriamente e 3 em grau II. Os achados em relação aos gangliogliomas foram também estudados separadamente. Este estudo sugere que a inclusão da eletrocorticografia e da ressecção das margens epileptogênicas em pacientes com LOEs e epilepsia refratária melhoram os resultados obtidos em relação às crises. PALAVRAS-CHAVE: tumor cerebral, ganglioglioma, epilepsia refratária, eletrocorticografia.The surgical treatment of space occupying lesions (SOLs) of the brain associated with refractory epilepsy is an issue dogged by controversy. In such patients, surgery is directed as much towards the relief of seizures, as it is towards cure of the tumor. Many such patients are on supra-maximal doses of anticonvulsant therapy, freedom from which is another important goal. Many neurosurgeons believe that simple excision of the lesion alone is inadequate for this purpose'.

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Relief of Seizures from a Predominantly Posterior Temporal Tumor with Anterior Temporal Lobectomy

Cited by 39 publications

References 10 publications

Epileptogenic Foci on Subdural Recording in Intractable Epilepsy Patients with Temporal Dysembryoplastic Neuroepithelial Tumor

Epileptogenic Foci on Subdural Recording in Intractable Epilepsy Patients with Temporal Dysembryoplastic Neuroepithelial Tumor

Clinico-electrical Characteristics of Lateral Temporal Lobe Epilepsy; Anterior and Posterior Lateral Temporal Lobe Epilepsy

Surgical treatment of refractory epilepsy associated with space occupying lesions experience and review

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