Seizure outcome of lesionectomy in glioneuronal tumors associated with epilepsy in children

Giulioni, Marco; Galassi, Ercole; Zucchelli, Mino; Volpi, L.

doi:10.3171/ped.2005.102.3.0288

Cited by 64 publications

(63 citation statements)

References 51 publications

(117 reference statements)

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“…39,40,68 Therefore, considering the good prognosis for epilepsy and the possible, although low, risk of malignant transformation, we think that ELGTs should be properly and quickly diagnosed by adequate imaging investigations and considered early for surgical treatment, particularly in young patients, to avoid psychosocial consequences and disability due to long-standing medically intractable seizures. 23,31,33,34,41,42,44,45,76,99 In our group of 17 patients with isolated FCD, we identified FCD Type IIa in 11 patients, FCD Type Ic in 6 patients. Of the patients with FCD Type IIa, 8 (72.7%) had Class I outcomes, 7 of them (63.6% of the FCD IIa group) had Class IA, whereas considering FCD Type Ic, (Engel Class I outcome was observed in 2 (33.3%) of 6 patients, with only 1 patient (16.6%) having a Class IA outcome.…”

Section: Discussionmentioning

confidence: 92%

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: 92%

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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“…Although some authors reported that good seizure control can be obtained despite incomplete tumor resection, 11,12 the importance of total tumor removal for seizure control has been emphasized by many authors, especially in recent studies. 4,5,13 However, Daumas-Duport et al 14 reported…”

Section: 10mentioning

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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“…Long-term clinical follow-up typically shows no evidence of recurrence, even in patients with incomplete surgical resection ( 76,97,99,102,107,126). Risk factors for post operative recurrent seizures at long-term follow-up include longer pre-operative history of seizures, cortical dysplasia next to DNT and residual tumour ( 85,100,127,128). Malignant transformation is extremely rare, only 2 cases reported from 700 cases of DNTs (129).…”

Section: Prognostic Factorsmentioning

confidence: 99%

Neuronal and Mixed Neuronal-Glial Tumors of the Central Nervous System

Barbarawi¹,

Allouh²,

Qudsieh³

2012

Histopathology - Reviews and Recent Advances

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Seizure outcome of lesionectomy in glioneuronal tumors associated with epilepsy in children

Abstract: The results of this study indicate that lesionectomy may provide good long-term seizure control in the majority of children with epileptogenic glioneuronal tumors.

Cited by 64 publications

References 51 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

Neuronal and Mixed Neuronal-Glial Tumors of the Central Nervous System

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