Glioneuronal Tumours and Epilepsy: Clinical Features and Results of Surgery in a Series of 27 Cases.
Abstract number :
2.308
Submission category :
Year :
2001
Submission ID :
2970
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
M. Giulioni, MD, Dept.of Neurological Sciences, Bellaria Hospital, Bologna, Italy; G. Rubboli, MD, Dept of Neurological Sciences, Univ of Bologna, Bellaria Hospital, Bologna, Italy; R. Federico, MD, Dept.of Neurological Sciences, Univ.of Bologna, Bellaria
RATIONALE: To describe a group of 27 patients presenting with glioneuronal tumours (GNT) and epilepsy, and to report the results of surgical treatment.
METHODS: From January 1992 to December 2000, 36 patients were surgically treated for GNT. 27 cases out of 36 presented epileptic seizures as only clinical symptom; the mean age was 27 years (range 6-61 years); 13 were females, 14 males. All patients underwent routine EEG and brain MRI/CT scan. In all patients, lesionectomy was performed.
RESULTS: The mean interval between the onset of seizures and surgery was 10 years (range 2 months-35 years). Types of seizure were complex partial seizures in 19 cases (70.3 %), simple partial seizures in 8 cases (29.7 %); secondary generalization could occur in 12 cases (44.4 %). Seizure frequency was: sporadic in 2 cases, monthly in 4 cases, weekly in 11 cases, several per week in 4 cases, daily/several per day in 6 cases. The site of the tumour was temporal in 18 cases (66.6%), extratemporal in 9 cases (33.3%). The ablation of the tumor was total in 22 patients (81.4 %), subtotal in the remaining 5 patients (18.5 %). Histopathological examination demonstrated a ganglioglioma in 23 patients, a dysembrioplastic neuroepitelioma in 4. Post-surgery complications were cerebellar hemorrage (2 cases), quadrantanopia (1 case), transitory aphasia (1 case), transitory third nerve deficit (1 case), transitory psichotic disturbances (1 case). Mean follow-up was 4 years (range 5 months-8 years). No recurrence of tumour was observed. 18 patients were seizure-free (Engel Class I) (66.6 %) (2 of them had withdrawn antiepileptic treatment); mean age at surgery: 13,3 years. 9 patients showed a decrement of seizure frequency (Engel Class II) (36.6 %); mean age at surgery: 22.8 years. No relationships was observed between the outcome (Engel Class I or II) and site of the tumour, total or subtotal ablation of the tumor, duration of epilepsy, seizure frequency. A better outcome (Class I versus Class II) was associated with surgery at a younger age (p[lt]0.01).
CONCLUSIONS: In our patients with epilepsy associated with GNT, lesionectomy could lead to a good outcome (Engel Class I) regardless of epilepsy duration, seizure frequency, site and extension (total or subtotal) of the ablation of the tumour. A significant prognostic factor for a better seizure outcome resulted to be a younger age at surgery.
Support: Grant MURST 40%.