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Surgical treatment of neuronal-glial tumors of mesial-basal part of temporal lobe: Long term outcome and control of epilepsy in pediatric patients
Affiliations- Department of Neurosurgery, The Children's Memorial Health Institute, Head: professor Marcin Roszkowski, Warsaw, Poland
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Abstract
Neuronal-glial tumors (ganglioglioma and dysembryoplastic neuroepithelial tumor) are a frequent cause of focal, drug-resistant and epilepsy in children and young adults, that is amenable for surgical treatment.
Aim of paperAssessment of late outcome of surgical treatment and degree of seizure control, as well as prognostic significance of selected clinical factors.
Material and method52 Pediatric patients presenting with epilepsy, lesion of mesio-basal temporal lobe and histologically verified neuronal-glial tumor treated at our facility since 2000–2011.
ResultsAfter the mean follow-up of 2.94 years, satisfactory treatment outcome (Engel classes I and II) was obtained in 92% of the patients (n=48). Poor outcome (Engel class III) was seen in 8% of patients (n=4). New neurological deficits appeared in 28% of the patients (n=20) but in most of them resolved over time.
ConclusionsIn patients with drug-resistant epilepsy and a lesion of mesial-basal part of temporal lobe suggestive of a glial-neuronal tumor, surgical treatment is strongly recommended, aiming at excision of tumor and elimination of seizures. Histological verification of the lesion is a pre-requisite for optimal treatment planning. In most patients, both treatment goals may be reached. Short duration of epilepsy prior to surgery and young age are favorable prognostic factors. Histological diagnosis of GG, co-existence of cortical dysplasia and location of tumor extending beyond mesial-basal temporal structures are associated with a higher risk of postoperative complications. These may out-weight expected benefits of surgery.
Abstract
Neuronal-glial tumors (ganglioglioma and dysembryoplastic neuroepithelial tumor) are a frequent cause of focal, drug-resistant and epilepsy in children and young adults, that is amenable for surgical treatment.
Aim of paperAssessment of late outcome of surgical treatment and degree of seizure control, as well as prognostic significance of selected clinical factors.
Material and method52 Pediatric patients presenting with epilepsy, lesion of mesio-basal temporal lobe and histologically verified neuronal-glial tumor treated at our facility since 2000–2011.
ResultsAfter the mean follow-up of 2.94 years, satisfactory treatment outcome (Engel classes I and II) was obtained in 92% of the patients (n=48). Poor outcome (Engel class III) was seen in 8% of patients (n=4). New neurological deficits appeared in 28% of the patients (n=20) but in most of them resolved over time.
ConclusionsIn patients with drug-resistant epilepsy and a lesion of mesial-basal part of temporal lobe suggestive of a glial-neuronal tumor, surgical treatment is strongly recommended, aiming at excision of tumor and elimination of seizures. Histological verification of the lesion is a pre-requisite for optimal treatment planning. In most patients, both treatment goals may be reached. Short duration of epilepsy prior to surgery and young age are favorable prognostic factors. Histological diagnosis of GG, co-existence of cortical dysplasia and location of tumor extending beyond mesial-basal temporal structures are associated with a higher risk of postoperative complications. These may out-weight expected benefits of surgery.
Keywords
Neuronal-glial tumor, Mesial-basal temporal lobe, Epilepsy, Children
About this articleTitle
Surgical treatment of neuronal-glial tumors of mesial-basal part of temporal lobe: Long term outcome and control of epilepsy in pediatric patients
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
2-8
Published online
2017-04-19
Page views
405
Article views/downloads
381
DOI
10.1016/j.pjnns.2017.04.001
Bibliographic record
Neurol Neurochir Pol 2018;52(1):2-8.
Keywords
Neuronal-glial tumor
Mesial-basal temporal lobe
Epilepsy
Children
Authors
Paweł Daszkiewicz
Paweł Kowalczyk
Marcin Roszkowski
