Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Effective chemotherapy using PCV (procarbazine, lomustine and vincristine) has been documented in anaplastic oligodendrogliomas and oligoastrocytomas. A pilot study using PCV was conducted for relapsing patients with anaplastic oligodendrogliomas and oligoastrocytomas. Preliminary results are reported. Fourteen patients were enrolled. All received at least two courses of PCV and were evaluable for response. Eleven patients (78%) responded to chemotherapy with complete responses in 2 patients. Response was more obvious regarding contrast enhanced areas than volumes changes (11 responses versus 7). A story of seizure was the main clinical prognostic factor for response. All toxicities were manageable and no treatment related death occurred. Chemotherapy is an effective treatment in aggressive oligodendrogliomas. Further studies must assess the role of chemotherapy in the multidisciplinary management of oligodendroglioma.
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PMID:[Assessment of procarbazine, vincristine and lomustine association (PCV protocol) in oligodendroglioma and mixed glioma]. 943 96

A 31-year-old woman with a five year history of seizures complained of worsening fatigue and attention deficits. At age 26, neuroradiological imaging studies had shown a small, non-enhancing hypodense lesion involving the left frontobasal and subcallosal region. Follow-up CT and MRI images showed that the lesion had not changed. A stereotactic biopsy showed a dysembryoplastic neuroepithelial tumor (DNT). The lesion was subtotally resected and the diagnosis of DNT was fully confirmed. However, the distinction between oligodendroglioma, ganglioglioma, focal dysplastic cerebral cortex, and DNT was only possible with knowledge of the clinical and neuroradiological data.
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PMID:Case of the month: May 1997--a 31 year old woman with seizures, fatigue and attention deficits. 945 79

We report a case of an oligodendroglioma associated with a cavernous angioma. The patient, a 20-year-old man with an 8-year history of epileptic seizures, presented an acute onset of headache, nausea, and vomiting. Computerized tomographic scan and angiogram revealed multiple vascular malformations in both hemispheres including a cystic hemorraghic lesion with a perifocal edema attributing to a mass effect. Repeated puncture of the cyst failed to give improvement of elevated intracranial pressure. At surgery, the cyst and the underlying lesion were excised and found to be oligodendrocyte-rich tissue with malformed vascular tissue. Final histological examination revealed an oligodendroglioma associated with a cavernous angioma. As concurrence of oligodendroglioma and vascular malformation is rare, this case raises a broad range of differential diagnoses such as reactive oligodendroglial gliosis due to a vascular malformation, unusual vascularity of an oligodendroglioma as well as other kinds of cerebral tumors or malformations. The diagnostic difficulties as well as the pathogenetic and pathological significance of the concurrence of an oligodendroglioma and cavernous angioma are discussed.
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PMID:Association of oligodendroglioma-like cell proliferation and angiomatous vasculature--coincidence or pathogenetically related lesions? 956 27

Pediatric oligodendrogliomas are infrequently occurring brain tumors and frequently thought of as benign. The literature examining treatment and outcome in this select population is sparse. A retrospective analysis of pediatric oligodendrogliomas treated at MD Anderson Cancer Center between 1973 and 1992 was performed. Oligodendrogliomas were histologically graded according to the method of Smith. Survival data were estimated with Kaplan-Meier curves. Mean follow-up was 39.7 months. Nineteen children had histologically verified oligodendrogliomas and mixed oligodendroglioma/astrocytoma (M:F = 11:8; age range 1-18 years, mean = 13.1). Presenting symptoms included seizures (n = 10), headache (n = 3), visual field defects (n = 2), weakness (n = 2), cranial nerve palsy (n = 1) and decreased school performance (n = 1). All patients underwent craniotomy: 13 subtotal resections, 5 gross total resections and 1 biopsy. Twelve children had adjuvant therapy including radiation (n = 12), chemotherapy (n = 5) or both (n = 5). The 5-year survival was 65%. Seizure frequency was reduced in 30%. Children with oligodendrogliomas do not have a benign course, but younger children (<12 years) have a better prognosis. Histologic classification correlates with survival. Completeness of resection was not found to be a factor relating to survival. No conclusions can be drawn concerning adjuvant therapy because of selection bias.
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PMID:Pediatric oligodendrogliomas. 970 89

Meningioangiomatosis (MA) is a rare, benign, focal lesion of the leptomeninges and underlying cerebral cortex characterized by leptomeningeal and meningovascular proliferation. It may occur sporadically or in association with neurofibromatosis type 2. Previous reports have emphasized histological and imaging features. Data on the management of these patients are sparse, and electrophysiological features of MA lesions have not been published. We assessed the clinical, electrophysiological, histopathological and imaging features as well as the surgical outcome in MA, and compared MA with and without neurofibromatosis. Seven patients with MA at our centre were investigated and their outcome was assessed. A review of the literature is included. MA exhibits a wide range of clinical, imaging, histopathological and electrophysiological features, making the diagnosis difficult. Sporadic MA cases are not associated with neurofibromatosis and the two disorders are genetically distinct. Medically refractory, localization-related epilepsy is the commonest presentation in sporadic cases, but atypical presentations also occur. Unlike sporadic cases, MA with neurofibromatosis is often found incidentally, does not produce seizures, occurs less frequently (ratio of 1:4), and is multifocal. MRI findings in MA correspond to the histological picture. However, the appearance on imaging is non-specific and may suggest cystic atrophy, angioma and tumours. Several abnormalities have been found in close proximity to MA lesions, i.e. meningioma, oligodendroglioma, arteriovenous malformation, encephalocoel and orbital erosion. In spite of histopathological diversity, MA lesions are either predominantly cellular or vascular. Immunohistochemical results are inconsistent among cases, add little to the diagnosis, and do not support a meningeal origin. Electrocorticographic recordings from the surface and within MA lesions revealed a spectrum of electrophysiological expressions. Intrinsic epileptogenicity of MA lesions was documented in some cases. Epileptogenicity was confined to the perilesional cortex in some patients and it was complex (extralesional, multifocal, generalized) in others. Only 43% of our patients became seizure-free postoperatively compared with 68% previously reported, and >70% of our patients and those in the literature continued to require antiepileptic drugs. This is in keeping with the diverse electrophysiology of MA and suggests a less optimistic postoperative outcome than previously recognized.
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PMID:Meningioangiomatosis. A comprehensive analysis of clinical and laboratory features. 1021 83

Two cases of unexpected death in persons with epileptic seizures due to a brain tumor are presented which encompassed an astrocytoma WHO grade II and an anaplastic astrocytoma WHO grade III. A 35-year-old man was found somnolent and disoriented at home. A computed tomography (CT) scan revealed a tumor of the right frontal lobe suggestive for an oligodendroglioma. During an angiographic examination the patient experienced an epileptic seizure. Some weeks later, the man was found dead in front of his house with a fresh bite mark of the tongue. Neuropathological examination revealed an astrocytoma WHO grade II of the right frontal lobe. A 47-year-old man plunged into a swimming-pool and was found submerged some minutes later. After resuscitation he survived comatose for 8 days but finally died due to severe hypoxic brain damage. He had been operated on a brain tumor of the temporal lobe 1 year before the accident. Neuropathological examination revealed residual tumor tissue at the operation site corresponding to an anaplastic astrocytoma WHO grade III. Although rare, death in persons with epileptic seizures due to brain tumors is an important mechanism of death encountered by the forensic pathologist.
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PMID:Unexpected death in persons with symptomatic epilepsy due to glial brain tumors: a report of two cases and review of the literature. 1035 81

Oligodendrogliomas account for 4-5% of primary central nervous system tumours with a slow and infiltrative growth. We report the clinical and pathological findings of 15 cases of oligodendrogliomas. Eight patients were males and 7 were females. The ages ranged between 17 and 66 years, with a mean of 39.73 years. The symptoms reflected the growth and topography of the tumours; migraine (60%) and seizures (60%) were the most frequent symptoms. Frontal (n = 6), parietal (n = 2), temporal (n = 1) and occipital (n = 1) lobes were affected. Five patients undergone total resection of the tumor and 10 were submitted to partial resection, from which 3 received adjuvant radiotherapy, 1 adjuvant chemotherapy and 1 chemotherapy and radiotherapy. The overall recurrence rate was 60% for a 32 month follow up. Five recurrences were observed in patients submitted only to the surgical treatment and 4 in which adjuvant radio or chemotherapy were performed. These results are similar with the literature and may contribute to further understanding the biological behavior of these rare tumours.
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PMID:[Oligodendroglioma: a pathological and clinical study of 15 cases]. 1041 25

Indications of surgical treatment for lesions in functional cerebral areas depend on the ratio between the definitive neurological deficit and the beneficial effect of resection. Detection of eloquent cortex is difficult because of important individual variability. Peroperative direct cortical and subcortical electrical stimulations (DCS) provide the most precise and reliable method currently available allowing identification and preservation of neurons essential for motricity, sensitivity++ and language. We report our preliminary experience with DCS in surgery of intracerebral infiltrative tumors with a consecutive series of 15 patients operated from November 96 through September 97 in our institution. Presenting symptoms in the 15 patients (8 males, 7 females, mean age 43 years) were seizures in 11 cases (73%) and neurological deficit in 4 cases (27%). Clinical examination was normal in 11 patients and revealed hemiparesia in 4. Magnetic resonance imaging (MRI) with three-dimensional reconstruction showed a precentral tumor in 10 cases, central lesion in one patient, postcentral lesion in two cases, right insular tumor (non-dominant hemisphere) in one case. All patients underwent surgical resection using DCS with detection in 13 cases of motor cortex and subcortical pathways under genera anesthesia, in one case of somatosensory area under local anesthesia, and in one case of language areas also under local anesthesia. The tumor was recurrent in two patients had been operated earlier but without DCS. Resection, verified by postoperative MRI, was total in 12 cases (80%) and estimated at 80% in 3 patients. Histological examination revealed an infiltrative glioma in 12 cases (8 low grade astrocytomas, 3 low grade oligodendrogliomas, and one anaplastic oligodendroglioma), and metastases in 3 cases. Eight patients had no postoperative deficit, while the other 7 patients were impaired, with, in all cases except one, complete recovery in 15 days to 2 months. Direct cortical and subcortical electrical stimulations offer a reliable, precise and safe method, allowing functional mapping especially useful in case of infiltrative cerebral tumors in eloquent areas. This technique allows improvement in the quality of tumoral resection and concurrently a minimization of the risk of definitive postoperative neurological deficit.
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PMID:[Preoperative direct cortical and sub-cortical electric stimulation during cerebral surgery in functional areas]. 1048 45

A case of right temporal lobe oligodendroglioma in an 8-year-old female is reported. This case is unusual, because of the rarity of this type of tumour in children, because it was accompanied by seizure activity which is atypical, and because it highlights the difficulties in diagnosis. Prior to diagnosis, the background had included normal early development, followed by gradual development of partial complex seizures with poor response to medication in the absence of clear findings on EEG or CT. Considered to have been present prior to 1 year of age, the tumour was purported to be the aetiological base for seizure activity, which ceased after surgical excision. Post-surgical difficulties with academic progress and behaviour resulted in referral for neuropsychological evaluation, which revealed lowered overall cognitive functioning with deficits in processing speed, abstract verbal reasoning, concept formation, visual perception, visual reasoning, scanning, attention, memory, academic attainment and learning, and clerical motor speed. Behavioural functioning revealed impairment in social skills, irritability, impulsivity, and mood changes. The relative contributions of medication (adverse reaction and toxicity), long term seizure activity, early age of onset, and presence/excision of tumour are difficult to ascertain specifically. Findings appear consistent with those of right temporal lobe brain injury.
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PMID:Neuropsychological assessment of an 8-year-old child following excision of a right temporal lobe oligodendroglioma. 1050 53

We report the case of a middle aged woman who developed refractory complex partial seizures in her early twenties. She had a right coloboma and neurological examination was normal. Neuropsychological assessments revealed mild impairments of non-verbal memory, and visuospatial and constructional difficulties. Serial CT and MRI showed multiple nodular abnormalities in her mid-brain, diencephalon, subependymal region and both mesial temporal lobes. EEG recording revealed a right medial temporal focus. She underwent en bloc temporal lobectomy. The surgical pathology revealed mesial temporal dysembryoplastic neuroepithelial tumour (DNET) in association with extensive, contiguous neocortical dysplasia. The proliferation marker MIB-1 revealed up to 2% labelling in tumour areas resembling conventional oligodendroglioma. In the two years since surgery she has been seizure free and the remaining MR brain abnormalities have not changed. The very unusual centripetal MRI pattern of discrete multifocal lesions with the characteristic T1 and T2 features of DNET would support the dysembyroplastic germinal origin that was proposed by Daumas-Duport et al. (1988) in their original description of the lesion. The neuroradiological, neuropathological and clinical features of this case are compared with the two previous cases of multifocal DNET.
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PMID:Dsyembryoplastic neuroepithelial tumour with discrete bilateral multifocality: further evidence for a germinal origin. 1104 13


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