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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This is a retrospective study of 21 surgically treated patients with temporal lobe tumors and epilepsy. Evaluation included clinical data, EEG findings, structural scans, pathological diagnosis and post-surgical follow-up. There were 9 cases of ganglioglioma, 5 pilocytic astrocytoma, 3 ganglioneuroma, 2 dysembryoplastic neuroepithelial tumor, 1 pleomorphic xantoastrocytoma, and 1 meningioangiomatosis. Mean follow-up time was 22 months and outcome was evaluated according to Engel's classification; 76.2% were classified in class I and 23.8% in II and III. All patients classes II and III had been submitted to mesial and neocortical resections. There were no differences related to clinical characteristics, pathological diagnosis or duration of follow-up in patients seizure-free or not. All patients had abnormal MRI and ten of these had normal CT; the MRI characteristics were compared to pathological diagnosis and specific histological characteristics of the tumors were not discernible by MRI. We concluded that MRI was essential for the diagnosis and precise location of TL tumors. Ganglioglioma was the most frequent tumor and lesionectomy associated to mesial resection doesn't guarantee a better prognosis.
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PMID:Clinical characteristics and surgical outcome of patients with temporal lobe tumors and epilepsy. 1110 64

We report the case of a 26-year-old male who was operated on after an acute episode complicating a long history of seizures. The resected temporal lesion was an anaplastic ganglioglioma. Ganglioglioma is a tumor of children and young adults, characterized by two cell components, neuronal and glial. It is usually a benign lesion. The present case is remarkable in several aspects. Hemorrhage led to the discovery of a supra-tentorial tumour. Microscopic examination revealed anaplastic foci in an otherwise typical lesion. There was a long past medical history but outcome was rapidly unfavorable after surgical resection and associated with dissemination along the spinal cord.
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PMID:[Anaplastic temporal ganglioglioma with spinal metastasis]. 1122 61

Gangliogliomas are an increasingly recognized cause of epilepsy in children. In this study the clinical, neuroimaging, and neurophysiological data of five patients with cerebral ganglioglioma and epilepsy are reviewed retrospectively. The average age of these patients was 4.4 years at onset and the average duration of seizures before diagnosis was 11 months. Tumors were located in the frontal (3), parietal (1), and occipital (1) lobes. While one cystic and four solid tumors showed various densities on CT and MRI, one frontal lesion was not demonstrated by CT scan but clearly shown by MRI. Scalp electroencephalography (EEG) showed neither localized nor epileptiform abnormalities in three patients, while the remaining two had these abnormalities. In one patient, invasive chronic electrocorticography (ECoG) recordings with subdural electrodes revealed an ictal onset zone located in the hand motor area. In all patients, intraoperative ECoG failed to reveal any epileptiform activities, and tumor removal alone was performed. For a mean of 3.4 years after surgery, all patients are alive and seizure-free, with stable imaging findings. Tumor resection may be the most important factor for optimal seizure control and prevention of tumor recurrence despite the fact that EEG and ECoG findings may conflict on tumor location.
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PMID:Cerebral ganglioglioma with epilepsy: neuroimaging features and treatment. 1133 62

Nerve cell tumours of the cerebrum tend to display a high degree of morphological variability from case to case, and this leads to poor understanding of these tumours. We retrospectively reviewed the clinical and patho-anatomic features of 16 primary nerve cell tumours of the cerebrum (M:9; F:7; average age at onset: 10.2 years). Intraventricular tumours were not included. In 13 patients epileptic seizures were the only symptoms, while three had headache or hemiparesis. Seven tumours were located in the frontal lobe, four in the parietal lobe, two in the temporal lobe and one each in the fronto-parietal lobes, occipital lobe and the midbrain. Tumours were histologically classified into three groups. In the first group, six tumours had the morphological features of classic gangliocytoma or ganglioglioma. In the second group six cerebral and midbrain tumours were composed of small cells, which showed apparent neuronal differentiation including positive immunoreactivity for synaptophysin and the presence of synaptic structures. These tumours usually involved both the cortex and white matter. In the third group, three tumours were composed of small nerve cells and ganglioid cells. All tumours were relatively well circumscribed, and thus eight tumours were totally removed, five subtotally and three partially. Following surgery, three patients, except one, are alive with stable imaging findings for 4 months - 19.3 years (average 11.6 years) after treatment. While small nerve cell tumours are found throughout the cerebrum and its identification broadens the spectrum of neuronal and mixed neuro-glial tumours, most of these tumours are biologically indolent.
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PMID:Nerve cell tumours of the cerebrum: variable clinical and pathological manifestations. 1138 95

The cerebellum is known to have an inhibitory effect on seizures. Nevertheless, cerebellar dysplastic lesions can be epileptogenic. A 4-month-old infant had paroxysmal facial contractions; tachypnea and nystagmoid eyeball and tremulous movements were occasionally combined. These evolved to stereotypic clinical patterns and frequencies, which increased despite administration of antiepileptic drugs (AEDs). Magnetic resonance imaging (MRI) demonstrated a mass arising from the superior cerebellar peduncle, although video-scalp EEG monitoring revealed no abnormal findings. Positron emission tomography with [(18)F]fluorodeoxyglucose revealed focal hypermetabolism in the same area identified by MRI. A depth electrode implanted in the mass revealed focal spike-and-wave discharges. The lesion was partly removed; pathologic diagnosis was ganglioglioma. Because of incomplete seizure control and residual tumor visible on MRI, a second operation was performed. After complete excision of the tumor, the patient became seizure free without AEDs. This case confirms the presence of seizure originating from the cerebellum and emphasizes the need for the complete removal of an epileptogenic lesion.
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PMID:Hemifacial seizure of cerebellar ganglioglioma origin: seizure control by tumor resection. 1158 Jul 71

Glial neoplasms that are peripherally located and involve the cortical gray matter are noteworthy because of their predilection to serve as a seizure locus, their amenability to surgical resection, their generally favorable prognosis, and their characteristic imaging features, which facilitate diagnosis before surgery. The smaller lesions include ganglioglioma and dysembryoplastic neuroepithelial tumor. Gangliogliomas contain both neuronal and glial components and occur most commonly in the temporal lobe. Variant forms of gangliogliomas may occur and are related to the different compositions of the underlying cellular population. Gangliocytomas lack glial cells and are located both in the cerebral hemispheres and the cerebellum. Lhermitte-Duclos disease represents a specific type of cerebellar gangliocytoma with dysplastic features and is characterized by a laminar pattern at imaging. Dysembryoplastic neuroepithelial tumors occur predominantly in children and young adults with partial seizures and most commonly arise in the temporal lobe, frequently in combination with cortical dysplasia. Surrounding vasogenic edema is conspicuously absent in both gangliogliomas and dysembryoplastic neuroepithelial tumors. The larger masses in this group include desmoplastic infantile ganglioglioma and pleomorphic xanthoastrocytoma and tend to involve the leptomeninges and cortical territory. Both invoke an intense desmoplastic reaction, which appears as an enhancing soft-tissue component at imaging.
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PMID:From the archives of the AFIP: superficial gliomas: radiologic-pathologic correlation. Armed Forces Institute of Pathology. 1170 24

The September 2001 COM. A 51 year old man with refractory seizures presented with a recent seizure while at work but no other neurologic deficit. Imaging studies demonstrated a solid and cystic lesion of the right temporal lobe. Microscopic and immunohistochemical studies demonstrated an atypical ganglioglioma due to the presence of neurofibrillary tangles within the neoplastic ganglion cell component. This is the fifth case reported in the literature. Neoplastic ganglion cells and neurofibrillary tangles are discussed both separately and as integral components of this rare tumor.
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PMID:September 2001: 51-year-old man with seizures since childhood. 1177 Aug 98

Gangliogliomas are rare but mostly benign tumors of the central nervous system. Early surgical resection is recommended to prevent seizures and further growth. Therefore, an uncal herniation caused by a ganglioglioma is a very rare event. We report such a case, where a patient with an initially small lesion was lost to follow-up.
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PMID:Ganglioglioma causing acute uncal herniation. 1191 10

The authors present their results with epilepsy surgery of the temporal lobe performed during a 5 years period at the Hospital of the University of Jordan, in 12 patients. All patients underwent comprehensive presurgical evaluation, including neurological history, examination, video-Electroencefalogram, Electroencephalogram for intercritical and habitual seizures and optimum magnetic resonance. After appropriate selection, we performed epilepsy surgery in 12 patients (9 males and 3 females). The mean age at operation was 21.4 years (range 4-44 years). All patients were receiving high therapeutic doses of antiepileptic therapy. Abnormal findings in Magnetic Resonance were observed in all cases. Pre and post resection electrocorticogram were recorded and graded according to Jay Scale. Pathological findings showed, neoplasic lesion in 2 cases (16%); one ganglioglioma and a low grade astrocytoma) and 10 patients (84%) showed non-neoplasic lesions. Three patients (25%) had cortical dysplasia, another 3 (25%) had mesotemporal sclerosis, three more (25%) gliosis and one (8%) an arachnoid cyst. Post resection ECoG showed (84%) type A, (8%) type B, and (8%) type C. The present study has shown that intraoperative ECoG has an important role in the prediction of medically intractable epilepsy. Outcome of temporal lobe epilepsy surgery in our series was comparable to results reported by other authors despite of the absence of sophisticated functional tests.
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PMID:Surgical treatment of temporal lobe epilepsy. Personal experience. 1193 91

The most common cause of focal epilepsies is the morphological brain abnormality, the epileptogenic lesion. Nowadays, by using MRI, the epileptogenic lesion can be demonstrated in vivo in more and more cases. Our knowledge regarding the clinical and pathophysiological features of epilepsy should be reevaluated in the highlight of the epileptogenic lesions demonstrated by MRI. The presence and the type of the epileptogenic lesion are important prognostic factors in the pharmacological and surgical treatments of epilepsy. Because the localization of the lesion is usually identical with the site of the seizure onset, the MRI investigation play an important role not only in identifying the epilepsy etiology but also in the non-invasive localization of the epileptic focus. Tumors, malformations of the cortical development, the hippocampal sclerosis, perinatal lesions, posttraumatic scars and the vascular malformations are the most important morphological abnormalities associated with epilepsy. Low-grade astrocytoma, pilocytic astrocytoma, oligodendroglioma, ganglioglioma, and the dysembrioplastic neuroepithelial tumors are the most common neoplasms associated with chronic epilepsy. Low grade astrocytomas or vascular malformations generate seizures due to chemical or mechanical effects of the lesion, the pacemaker area occurs obviously outside the lesion, in the adjacent brain tissue. Conversely, malformations of cortical development have intrinsic epileptogenicity. In them, the seizure onset zone is localized intralesional: the lesion generates seizures itself.
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PMID:[Role of epileptogenic lesions in the development of ictal and interictal epileptic disturbance]. 1205 50


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