Temporal lobe gangliogliomas associated with chronic epilepsy: Long-term surgical outcomes

Abstract Objective To review the clinical features and surgical outcome in patients with temporal lobe gangliogliomas associated with intractable chronic epilepsy. Methods The Rush University Surgical Epilepsy Database was queried to identify patients with chronic intractable epilepsy who underwent...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2013-04, Vol.115 (4), p.472-476
Main Authors: Wallace, David, Ruban, Dmitry, Kanner, Andres, Smith, Michael, Pitelka, Lisa, Stein, Jonathan, Vannemreddy, Prasad S.S.V, Whisler, Walt W, Byrne, Richard W
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Anterior Temporal Lobectomy - adverse effects
Anterior Temporal Lobectomy - methods
Brain Neoplasms - pathology
Brain Neoplasms - surgery
Child, Preschool
Chronic Disease
Chronic epilepsy
Electroencephalography
Epilepsy
Epilepsy, Temporal Lobe - etiology
Epilepsy, Temporal Lobe - surgery
Female
Functional Laterality
Ganglioglioma
Ganglioglioma - pathology
Ganglioglioma - surgery
Humans
Image Processing, Computer-Assisted
Immunohistochemistry
Magnetic Resonance Imaging
Male
Middle Aged
Neurologic Examination
Neurology
Neurosurgery
Neurosurgical Procedures - adverse effects
Neurosurgical Procedures - methods
Pathology
Patients
Postoperative Complications - epidemiology
Supratentorial neoplasm
Surgery
Surgical outcomes
Temporal Lobe - pathology
Temporal Lobe - surgery
Temporal lobe tumor
Treatment Outcome
Young Adult
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Summary:Abstract Objective To review the clinical features and surgical outcome in patients with temporal lobe gangliogliomas associated with intractable chronic epilepsy. Methods The Rush University Surgical Epilepsy Database was queried to identify patients with chronic intractable epilepsy who underwent resection of temporal lobe gangliogliomas at Rush University Medical Center. Medical records were reviewed for age of seizure onset, delay to referral for surgery, seizure frequency and characteristics, pre-operative MRI results, extent of resection, pathological diagnosis, complications, length of follow-up, and seizure improvement. Results Fifteen patients were identified. Average duration between seizure onset and surgery was 14.3 years. Complex partial seizures were the most common presenting symptom. Detailed operative data was available for 11 patients – of these, 90.9% underwent complete resection of the amygdala and either partial or complete resection of the hippocampus, in addition to lesionectomy. Average follow-up was 10.4 years (range 1.6–27.5 years), with 14 patients improving to Engel's class I and one patient to Engel's class III. There were no recurrences, and permanent complications were noted in one patient. Conclusions Long-term follow-up of patients with temporal lobe gangliogliomas associated with chronic intractable epilepsy demonstrates excellent results in seizure improvement with surgery and increasingly low incidence of complications with improvements in microsurgical techniques.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2012.05.034