Seizure outcome of surgical treatment of focal epilepsy associated with low-grade tumors in children: Clinical article

Micol Babini, Marco Giulioni, Ercole Galassi, Gianluca Marucci, Matteo Martinoni, Guido Rubboli, Lilia Volpi, Mino Zucchelli, Francesca Nicolini, Anna Federica Marliani, Roberto Michelucci, Fabio Calbucci

Research output: Contribution to journalArticle

Abstract

Object. Low-grade tumor (LGT) is an increasingly recognized cause of focal epilepsies, particularly in children and young adults, and is frequently associated with cortical dysplasia. The optimal surgical treatment of epileptogenic LGTs in pediatric patients has not been fully established. Methods. In the present study, the authors retrospectively reviewed 30 patients (age range 3-18 years) who underwent surgery for histopathologically confirmed LGTs, in which seizures were the only clinical manifestation. The patients were divided into 2 groups according to the type of surgical treatment: patients in Group A (20 cases) underwent only tumor removal (lesionectomy), whereas patients in Group B (11 cases) underwent removal of the tumor and the adjacent epileptogenic zone (tailored surgery). One of the patients, who underwent 2 operations, is included in both groups. Follow-up ranged from 1 to 17 years. Results. Sixteen (80%) of 20 patients in Group A had an Engel Class I outcome. In this group, 3 of 4 patients who were in Engel Classes II and III had temporomesial lesions. All patients in Group B had temporomesial tumors and were seizure free (Engel Class I). In this series, in temporolateral and extratemporal tumor locations, lesionectomy yielded a good seizure outcome. In addition, a young age at seizure onset (in particular <4 years) was associated with a poor seizure outcome. Conclusions. Tailored resection in temporomesial LGTs was associated with excellent seizure outcome, indicating that an adequate presurgical evaluation including extensive neurophysiological evaluation (long-term videoelectroencephalography monitoring) to plan appropriate surgical strategy is advised.

Original languageEnglish
Pages (from-to)214-223
Number of pages10
JournalJournal of Neurosurgery: Pediatrics
Volume11
Issue number2
DOIs
Publication statusPublished - Feb 3 2013

Keywords

  • Glioneuronal tumor
  • Lesionectomy
  • Low-grade tumor
  • Oncology
  • Pediatric epilepsy surgery
  • Seizure outcome
  • Tailored resection

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Pediatrics, Perinatology, and Child Health

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