| Late recurrence of intractable epilepsy associated with MRI-occult pilocytic astrocytoma in the temporal lobe nine years after initial removal: a case report with surgical and late-seizure recurrence observations. | |
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MedLine Citation:
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PMID: 21970188 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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A 28-year-old male who presented a relapse of intractable epilepsy consisting of complex partial seizures with occasional secondary generalizations at the age of 26, had undergone removal of a left mesial temporal lobe tumor at another hospital at 18 years old. Pathological examination at that time revealed a low-grade astrocytoma, and the tumor was further treated by complementary adjuvant irradiation therapy. Magnetic resonance imaging (MRI) findings on admission portrayed a post-operative cavity anterior to the atrophied hippocampus on the left side with hyperintense in fluid-attenuated inversion recovery (FLAIR) images. There were no enhanced lesions in T1-weighted gadolinium images. As it was diagnosed as left mesial temporal lobe epilepsy with preoperative evaluations, the patient underwent left anterior temporal lobe resection (TLR). Intraoperative findings revealed that a small lump of grey tissue was attached to the anteromesial side of the sclerotic hippocampus. We surgically removed this and the tissue was a pilocytic astrocytoma. The patient has since remained seizure-free for 2.5 years. Seizure outcomes at postoperative 1-2 years are highly predictive of long-term outcomes after TLR for temporal lobe epilepsy (TLE). Late-seizure recurrence (> postoperative 2 years) with an initially successful outcome rarely occurs in TLR patients. This case report suggests that recurrence of even benign pilocytic astrocytomas may occur when seizure recurs in long-term follow-up. |
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Authors:
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Takeshi Nishimoto; Koji Iida; Kota Kagawa; Yosuke Watanabe; Yoshihiro Kiura; Akira Hashizume; Kazuhiko Sugiyama; Kaoru Kurisu |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Hiroshima journal of medical sciences Volume: 60 ISSN: 0018-2052 ISO Abbreviation: Hiroshima J. Med. Sci. Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-10-05 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0421060 Medline TA: Hiroshima J Med Sci Country: Japan |
Other Details:
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Languages: eng Pagination: 45-9 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734 - 8551, Japan. nishimot@hiroshima-u.ac.jp |
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