| Temporal lobe pleomorphic xanthoastrocytoma and chronic epilepsy: Long-term surgical outcomes. | |
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MedLine Citation:
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PMID: 21741164 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To review clinical features and surgical outcome in patients with temporal lobe pleomorphic xanthoastrocytomas (PXAs) and intractable epilepsy. METHODS: The Rush Surgical Epilepsy Database was queried to identify patients with chronic intractable epilepsy who underwent resection of a temporal lobe PXA at Rush University Medical Center. Medical records were reviewed for demographic, procedure and follow-up data. RESULTS: Four patients were identified with a temporal lobe PXA and intractable epilepsy. Average age of seizure onset was 16.5 years and delay to surgery was 90 months. Complex partial seizures were the most common presenting symptom, shown in all 4 patients, and 3 of 4 patients presented with simple partial seizures as well. Seizures occurred with an average frequency of 4 per month (range 1-12 per month). Detailed operative and post-operative follow up data was available for all 4 patients. Gross total resection of the tumor was achieved in all 4 cases. Three of 4 cases had complete resection of the amygdala, and 3 cases had resections of the hippocampus (one partial and two complete). On histopathology, all tumors were found to be low-grade, without mitoses or necrosis. Average follow-up was 120 months (range 29-296 months) with all 4 patients achieving Engel's class I outcome. At last follow up, there was no radiographic or clinical evidence of tumor recurrence. There were no permanent complications. CONCLUSIONS: Temporal lobe pleomorphic xanthoastrocytomas causing chronic intractable epilepsy occur in younger patients, and demonstrate excellent long-term results in seizure improvement and tumor control with surgery. We support the choice between simple lesionectomy and a tailored resection with amygdalohippocampectomy guided by preoperative findings, intraoperative electrocorticography, and the severity and chronicity of the patient's epilepsy. |
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Authors:
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David J Wallace; Richard W Byrne; Dmitry Ruban; Elizabeth J Cochran; David Roh; Walt W Whisler |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-6 |
Journal Detail:
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Title: Clinical neurology and neurosurgery Volume: - ISSN: 1872-6968 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7502039 Medline TA: Clin Neurol Neurosurg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier B.V. All rights reserved. |
Affiliation:
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Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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