Document Detail

Adult-onset epilepsy associated with dysembryoplastic neuroepithelial tumors.
MedLine Citation:
PMID:  18316209     Owner:  NLM     Status:  MEDLINE    
RATIONALE: Dysembryoplastic neuroepithelial tumors (DNET) are benign, localized lesions that typically cause localization-related epilepsy of childhood onset. Although excellent seizure outcomes are expected following surgical resection of focal, benign lesions, reports in pediatric epilepsy series suggest that this may not be the case with DNETs, which may exhibit complex and often multifocal epileptogenesis. We report the characteristics and surgical outcome of an adult- and childhood-onset cohort with this condition.
METHODS: Retrospective cohort of 23 patients seen at two major epilepsy centers, with localization-related epilepsy associated with histopathologically demonstrated DNETs. We assessed clinical, electrographic and surgical outcome features in patients with adult- and childhood-onset epilepsy. We were particularly interested in the level of congruence of EEG and MRI data and the need for intracranial recordings. We evaluated seizure outcomes at last follow-up.
RESULTS: The mean age was 33.3 years (range: 5-56 years). Ten patients had adult-onset epilepsy. Thirteen patients (57%) had simple partial, 21 (91%) had complex partial, 16 (70%) had secondarily generalized seizures and 5 patients had only simple partial seizures. Status epilepticus did not occur. Non-enhancing lesions on MRI were located in the temporal lobe in 17 patients, the frontal lobe in 3 patients and the parietal/occipital region in 2 patients. One patient had a DNET that involved both frontal and temporal areas. Ictal scalp EEG and MRI were congruent in 17 patients (74%). Eleven patients (48%) underwent lesionectomies, while the rest required some resection of extralesional cortex as well. Five patients required intracranial EEG. There was no association with cortical dysplasia. Seventeen patients (74%) had an Engel class 1 outcome, in a follow-up period that ranging from 5 to 98 months.
CONCLUSIONS: We found no difference in outcomes between adult- and childhood-onset cases. Although epileptogenicity was complex, congruence between electro-clinical and neuroimaging studies was high and allowed good surgical outcomes at 1 year of follow-up.
J G Burneo; J Tellez-Zenteno; D A Steven; N Niaz; W Hader; N Pillay; S Wiebe
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2008-03-07
Journal Detail:
Title:  Seizure     Volume:  17     ISSN:  1059-1311     ISO Abbreviation:  Seizure     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-05     Completed Date:  2008-12-12     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  498-504     Citation Subset:  IM    
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MeSH Terms
Brain Neoplasms / complications*
Child, Preschool
Cohort Studies
Electroencephalography / methods
Epilepsies, Partial / etiology*,  pathology,  physiopathology,  surgery
Magnetic Resonance Imaging / methods
Middle Aged
Neoplasms, Neuroepithelial / complications*
Retrospective Studies
Teratoma / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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