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

Ganglioglioma is increasingly recognized as being a cause of epilepsy. However, controversy still exists regarding the type of surgery required for optimal seizure control. To find out the factors associated with seizure outcome and to clarify treatment guidelines, a retrospective analysis of 29 epileptic patients who had pathologically proven gangliogliomas that were operated on at our institute during a 13-year period, was performed. There were 23 temporal and six extratemporal gangliogliomas, with a mean age of 16.5 years at surgery. Epilepsy was medically intractable in 14 (48.3%) patients. There were 26 temporal and six extratemporal resections including three re-operations. Three patients underwent intracranial electroencephalography (EEG) recordings (invasive monitoring). Intraoperative electrocorticography (ECoG) was performed in four patients. The mean duration of follow-up after surgery was 36.5 months. The Fisher's Exact test (two-tailed) was used to assess the association between the seizure outcome and several preoperative and operative parameters. Surgical treatment rendered most patients (75.9%, 22/29) seizure free. All three patients who underwent re-operation were seizure-free postoperatively. Eleven (47.8%) of the 23 temporal lobe gangliogliomas were associated with cortical dysplasia. Postoperative incomplete seizure control was associated with the presence of cortical dysplasia (p < 0.001). Good seizure outcome is expected in patients with gangliogliomas, despite years of medically intractable epilepsy, once the tumor is resected. Invasive monitoring/intraoperative electrocorticography is recommended for patients with suspected cortical dysplasia on MRI or for the patients with persistent epilepsy after ganglioglioma resection.
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PMID:Supratentorial ganglioglioma and epilepsy: postoperative seizure outcome. 1212 68

The issue of whether seizures can arise in the cerebellum remains controversial. The authors present the first known case of focal subcortical epilepsy with secondary generalization thought to arise from a dysplastic lesion within the cerebellum. A newborn infant presented with daily episodes of left eye blinking, stereotyped extremity movements, postural arching, and intermittent altered consciousness lasting less than 1 minute. These episodes began on his 1st day of life and progressively increased in frequency to more than 100 events per day. Antiepileptic medications had no effect, and interictal and ictal scalp electroencephalography (EEG) recordings demonstrated bilateral electrical abnormalities. Magnetic resonance imaging revealed a mass in the left cerebellar hemisphere, and ictal and interictal single-photon emission computerized tomography revealed a focal perfusion abnormality in the region of the cerebellar mass. The patient subsequently underwent intraoperative EEG monitoring with cortical scalp electrodes and cerebellar depth electrodes. Intraoperative EEG recordings revealed focal seizure discharges that arose in the region of the cerebellar mass and influenced electrographic activity in both cerebral hemispheres. Resection of this mass and the left cerebellar hemisphere led to complete resolution of the patient's seizures and normalization of the scalp EEG readings. Neuropathological findings in this mass were consistent with ganglioglioma. A review of the literature on the cerebellar origins of epilepsy is included.
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PMID:Focal motor seizures with secondary generalization arising in the cerebellum. Case report and review of the literature. 1213 11

Pure neuronal and mixed neuronal-glial tumors of the central nervous system are uncommon but fascinating because they are less aggressive than the more common glial tumors and their prognosis is excellent. Neurologic manifestations are varied and include seizures, symptoms of increased intracranial pressure, and neurologic deficits according to tumor location. Many neuronal tumors of the central nervous system demonstrate characteristic radiologic findings. At magnetic resonance (MR) imaging, gangliocytomas demonstrate low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and frequent enhancement on gadolinium-enhanced T1-weighted images. Characteristic MR imaging findings of Lhermitte-Duclos disease are a nonenhancing mass in a cerebellar hemisphere with a striated pattern. Central neurocytomas are typically located in the lateral ventricles near the foramen of Monro with a characteristic attachment to the septum pellucidum. Ganglioneurocytoma is a rare variant of central neurocytoma that is characterized by differentiation toward ganglion cells. In ganglioglioma, a well-defined cystic mass with a solid mural nodule is typically seen. Extension of enhancement to the leptomeninges is characteristic of desmoplastic infantile ganglioglioma and correlates with the firm dural attachment of the solid component. Dysembryoplastic neuroepithelial tumor has a well-demarcated, multilobulated or gyriform appearance.
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PMID:Neuronal tumors of the central nervous system: radiologic findings and pathologic correlation. 1223 46

In order to investigate the clinical characteristics, neuroimaging findings, pathological features, treatment, and outcomes, and to provide valuable guidance for the diagnosis and management of intracranial gangliogliomas, 34 cases of intracranial gangliogliomas were retrospectively analyzed. This study included 23 males and 11 females. Age at operation ranged from 17 days to 50 years. All patients had preoperative magnetic resonance imaging (MRI). Computed tomography (CT), magnetic resonance spectroscopy (MRS), 18F-FDG-PET (positron emission tomography), and 99Tc-HMPAO-SPECT (single photon emission computed tomography) were also performed in some cases. All pathological specimens and all available neuroimages were re-evaluated. The follow-up period varied from 12 to 89 months (mean 36 months). Seizure was the most common presenting symptom (85%). Tumor calcification was detected by CT scan in six of 11 cases. Seventeen gangliogliomas (50%) showed cystic components and 18 tumors (53%) were enhanced on MRI. All temporal lobe gangliogliomas were located intracortically and most of them had poor demarcation on MRI. In comparison with the contralateral normal area, the gangliogliomas showed a reduced Cho/Cr and NAA/Cr ratio, and an increased Cho/NAA ratio. On 18F-FDG-PET, gangliogliomas were usually hypometabolic. HMPAO-SPECT indicated tumor hypoperfusion or isoperfusion. A gross total resection was achieved in 25 patients. Tumor progression was observed in three patients who underwent an incomplete tumor resection. Two of them underwent a malignant transformation to a glioblastoma. Twenty-seven patients could carry on their normal life activity with the Karnofsky Performance Scale (KPS) of more than 80. Even though ganglioglioma is a slowly growing benign tumor, which could be demonstrated by magnetic resonance spectroscopy (MRS), PET, and SPECT, there is a chance of malignant transformation, especially in cases of incomplete tumor resection. Gangliogliomas should be resected gross totally, if feasible, to achieve the best long-term outcomes.
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PMID:Intracranial ganglioglioma: preoperative characteristics and oncologic outcome after surgery. 1224 Nov 12

A 48-year-old woman was admitted to the Neurosurgery Department for a large frontal lobe tumor revealed by partial seizures. The patient was conscious and alert. Neurological examination was normal. MRI study showed a right frontal lobe tumor compounded of an anterior solid mass strongly enhanced after gadolinium injection and a posterior voluminous cyst with important mass effect. The cerebral blood volume (CBV) map showed no area of elevated CBV within the tumor consistent with a low-grade tumor. The patient was operated on with a presumed diagnosis of anaplastic oligodendroglioma. Postoperative course was uneventful. Histopathological examination was consistent with a benign ganglioglioma. The patient did not undergo an additional treatment. One year later, the patient was healthy and neurological and neuropsychological examination were normal. MRI study did not show any recurrence. This case emphazises the relevance of perfusion MR imaging in the preoperative workup of glioneuronal and glial tumors.
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PMID:[Contribution of perfusion magnetic resonance imaging in a patient with cerebral ganglioglioma]. 1248 21

Gangliogliomas are rare tumors of the central nervous system. The definite role of postoperative radiotherapy has not been established. In studying three cases who underwent radiotherapy after subtotal resection, we evaluated the clinical, pathological, radiological features with follow-up of mean 8.1 years. All of three patients were male, and mean age was 22.3 years. All of the cases have temporal lobe lesions and, except for one, they all have seizures. Radiotherapy was given to all patients after surgery. Parallely opposed local fields were used. A total of 54 Gy in 5.5 weeks was given to the mid-plane using a Co-60 tele-therapy device. No recurrence, no new symptoms, and no new neurological deficiency were detected during follow-up.
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PMID:Postoperative radiotherapy for ganglioglioma; report of three cases and review of the literature. 1249 57

A solitary brain mass of a 4-month-old miniature dachshund showing seizure-like neurological signs was examined histopathologically. At necropsy a white tumor mass, replacing the thalamus, approximately 1.5 cm in diameter, was found. There was cystic space filled with yellowish pale fluid in the central area of the tumor mass. Histopathological examination revealed that the mass consisted of irregularly arranged well-differentiated neuronal and glial cells, and multifocal mineral deposits. The neuronal cells had a large clear nucleus and various amount of Nissl substances in the cytoplasm. Some neural cells were bi-nucleated. Neither mitotic figures nor proliferating cell nuclear antigen (PCNA)-positive nuclei was found in the neuronal cells. Immunostaining for glial fibrillary acidic protein (GFAP) revealed diffuse proliferation of GFAP-positive glial cells and their processes, while these glial cells did not show apparent cellular atypism, mitotic activity, or PCNA-immunoreactivity. Accordingly, the present tumor was diagnosed as ganglioglioma, and hamartomatous histogenesis might be possible.
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PMID:Ganglioglioma in the thalamus of a puppy. 1257 15

The September 2002 COM. A 24-year-old female presented with a history of 3 generalized seizures, the first of which had occurred 6 months before admission. Her neurological examination was normal, but upon admission her MRI showed a small cystic lesion in the left parieto-occipital region. The lesion was hyper-intense on T-2 weighted images and did not show contrast enhancment. At surgery, the tumor was found to be deep to the cortex and was a cyst with amber fluid surrounded by gliotic brain. Microscopically, the tumor was well-demarcated from the surrounding tissues, which showed reactive changes, including Rosenthal fibers. The tumor was composed of GFAP-positive glial cells, which were arranged in a pseudopapillary fashion around blood vessels. In between, the tumor cells were positive for neuronal markers. The diagnosis was papillary glioneuronal tumor (PGNT), a relatively recently described lesion that may be a variant of ganglioglioma. The current literature on PGNTs is reviewed.
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PMID:September 2002: 24-year-old female with a 6-month history of seizures. 1258 May 53

Cortical dysplasias or malformations due to abnormalities of cortical development are a well-recognized cause of intractable seizures. This study retrospectively examines the clinicopathologic features of 52 cases of extratemporal cortical dysplasia (from 135 total resections performed over a 16-year period). The study consists of 52 patients (27 males; 25 females) who underwent extratemporal resection for epilepsy at a mean age of 15.1 years (range, 3 months to 44.1 years). Seizure duration before surgery ranged from 7 to 372 months (mean duration, 129 months). Patterns of cortical dysplasia observed included diffuse architectural disorganization (n=48), neuronal cytomegaly (n=32), increased number of molecular layer neurons (n=32), balloon cells (n=19), gray matter heterotopia (n=3), neuronal glial clustering (n=3), and pial glial neuronal tissue (n=2). Five patients had coexistent nodular hamartomas. Coexistent tumors were present in five patients; including three dysembryoplastic neuroepithelial tumors, one ganglioglioma, and one low-grade fibrillary astrocytoma. Two patients had tuberous sclerosis. Follow-up was available in 50 patients (mean follow-up, 29 months). Thirty-eight patients (73%) had complete resolution or significant decrease in seizure frequency, 13 patients (25%) had increased seizures or no change in seizures, and one patient died in the postoperative period. In conclusion, (1). cortical dysplasia was identified in 38.5% of extratemporal resections for epilepsy; (2). the common cortical dysplasia patterns observed included diffuse cortical disorganization, neuronal cytomegaly, and increased molecular layer neurons; (3). 10% of extratemporal cortical dysplasia was associated with tumors; (4). improved seizure control was obtained in approximately three fourths of patients after resection; and (5). seizures associated with balloon cell dysplasia were less successfully managed with surgery.
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PMID:Cortical dysplasia in extratemporal lobe intractable epilepsy: a study of 52 cases. 1280 64

Four patients out of 52 patients with temporal lobe epilepsy (TLE), who underwent epilepsy surgery in our hospital since September of 1994, had cystic lesions in the temporal lobe and middle cranial fossa. Case 1 had old hematoma cavity in the inferior temporal gyrus and chronic subdural electrode recording revealed the ictal onset zone to be localized in the ipsilateral medial temporal region. Case 2 had cystic ganglioglioma in the temporal tip, and intraoperative electrocorticography demonstrated independent paroxysmal activities from medial temporal region and temporal tip near the cyst. Both area were resected and the patients became seizure free. Case 3 and 4 had arachnoid cysts in the middle cranial fossa. Chronic subdural electrode recording revealed that the ictal onset zone was localized in the ipsilateral inferior temporal gyrus (that had microdysgenesis) in Case 3 and contralateral medial temporal region (that had hippocampal sclerosis) in Case 4, respectively. These finding suggest that co-existence of extra-axial cyst such as Case 3 and 4 is incidental and that arachnoid cyst is less epileptogenic. However, intra-axial cyst such as Case 1 and 2 is epileptogenic and complicated physiological mechanism such as kindling phenomenon or secondary epileptogenesis may effect on the hippocampus. Comprehensive presurgical evaluation including electrocorticography is needed in the surgical treatment of TLE with cystic lesion.
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PMID:[Temporal lobe epilepsy associated with cystic lesion in the temporal lobe and middle cranial fossa]. 1288 3


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