Abstract
A series of 54 patients operated on for temporal epileptogenic lesions is reported: 36 had slow growing tumours, 18 supratentorial cavernous angiomas. The patients were divided into two different groups according to the presence of seizures controlled (group 1) or not controlled (group 2) by antiepileptic drugs (AEDs).
All the patients underwent preoperative scalp EEG and magnetic resonance imaging (MRI). They were operated on by pure lesionectomy, associated with amygdalo-hippocampectomy in 8 cases of uncontrolled seizures. Postoperatively they underwent MRI examination which revealed an incomplete lesionectomy in 12 cases.
Patients were followed up after surgery for at least 2 years, 6 of them were reoperated on for the persistence (or regrowth) of the tumour. The results of epilepsy outcome are reported. These cases underline the importance of preoperative electroclinical study, in order to determine the relationship between lesion location and epileptic focus. If good concordance is present, a complete lesionectomy is enough to cure the patient. In other cases associated amygdalo-hippocampectomy leads to better results, while more complicated cases may need preoperative stereo-EEG studies.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Awad IA, Rosenfeld J, Ahl J, Hahn JF, Lüders HO (1991) Intractable epilepsy and structural lesions of the brain; mapping, resection strategies, and seizure outcome. Epilepsia 32: 179–186
Berger SM, Ghatan S, Haglund MM, Dobbins Y, Ojemann GA (1993) Low grade gliomas associated with intractable epilepsy: seizures outcome utilizing electrocorticography during tumor resection. J Neurosurg 79: 62–69
Boon PA, Williamson PD, Fried I, Spencer DD, Novelly RA, Spencer SS, Mattson RH (1991) Intracranial, intraaxial, spaceoccupying lesions in patients with intractable partial seizures: an anatomoclinical, neuropsychological and surgical correlation. Epilepsia 32: 467–476
Bracchi M, Casazza M, Bradac GB, Avanzini G, Broggi G, Grisoli M (1994) Vascular anomalies in epilepsy. In: Shorvon AD et al (eds) Magnetic resonance scanning and epilepsy. NATO ASI Series. A 264. Plenum, New York, pp 191–193
Cascino GD (1990) Epilepsy and brain tumours: implications for treatment. Epilepsia 31[Suppl 3]: 37–44
Cascino GD, Jack CR jr, Sharbrough FW, Kelly PY (1994) Non-malignant tumoral lesions. In: Shorvon AD et al (eds) Magnetic resonance scanning and epilepsy. NATO ASI Series, A 264. Plenum, New York, pp 185–189
Del Curling O jr, Kelly DL, Elster AD, Craven TE (1991) An analysis of the natural history of cavernous angiomas. J Neurosurg 75: 702–708
Dodick DN, Cascino GD, Meyer FB (1994) Vascular malformations and intractable epilepsy: outcome after surgical treatment. Mayo Clin Proc 69: 741–745
Engel J (1987) Outcome with respect to epileptic seizures. In: Engel J (ed) Surgical treatment of the epilepsies. Raven, New York, pp 553–571
Engel J (1989) Basic mechanisms of epilepsy. In: Plum F et al (eds) Seizures and epilepsy, vol 31. FA Davis Company, pp 71–111
Ettinger AB (1994) Structural causes of epilepsy. Neurol Clin 12(1): 41–56
Fried I, Jung K, Spencer DD (1992) Hippocampal pathology in patients with intractable seizures and temporal lobe masses. J Neurosurg 76: 735–740
Fried I, Cascino GD (1993) Lesionai surgery. In: Engel J (ed) Surgical treatment of the epilepsies, 2nd ed. Raven, New York, pp 501–509
Goldring S, Rich KM, Picker S (1986) Experience with gliomas in patients presenting with a chronic seizure disorder. In: Little JR (ed) Clincial neurosurgery, vol 33. Williams and Wilkins, Baltimore, pp 15–42
Kahane P, Munari C, Hoffmann D, Tassi L, Gallina P, Francione S, Di Leo M, Quarato P, Lo Russo G, Benabid AL (1994) Approche chirurgicale multimodale des angiomes caverneux épileptogènes. Epilepsies 6: 113–130
Kraemer DL, Awad IA (1994) Vascular malformations and epilepsy: clinical considerations and basic mechanisms. Epilepsia 35[Suppl 6]: 30–43
Requena I, Arias M, Lopez-Ibor C, Pereiro I, Barba A, Alonso A, Monton E (1991) Cavernomas of the central nervous system: clinical and neuroimaging manifestations in 47 patients. J Neurol Neurosurg Psychiatry 54: 590–594
Robinson JR, Awad IA, Little JR (1991) Natural history of the cavernous angioma. J Neurosurg 75: 709–714
Spencer DD, Spencer SS, Mattson RH, Williamson PD (1984) Intracerebral masses in patients with intractable partial epilepsy. Neurology 34: 432–436
Vielvoye GJ, Pijl MEJ (1992) Magnetic resonance imaging of the so-called cerebral cryptic angiomas. Clin Neurol Neurosurg 94 [Suppl]: 171–175
Wyllie E, Lüders HO, Morris HN, Lesser RP, Dinner DS, Hahn J, Estes ML, Rothner AD, Erenberg G, Cruse R, Friedman D (1987) Clinical outcome after complete or partial cortical resection for intractable epilepsy. Neurology 37: 1634–1641
Author information
Authors and Affiliations
Editor information
Rights and permissions
Copyright information
© 1997 Springer-Verlag Wien
About this paper
Cite this paper
Casazza, M., Avanzini, G., Ciceri, E., Spreafico, R., Broggi, G. (1997). Lesionectomy in Epileptogenic Temporal Lobe Lesions: Preoperative Seizure Course and Postoperative Outcome. In: Ostertag, C.B., Thomas, D.G.T., Bosch, A., Linderoth, B., Broggi, G. (eds) Advances in Stereotactic and Functional Neurosurgery 12. Acta Neurochirurgica Supplements, vol 68. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6513-3_12
Download citation
DOI: https://doi.org/10.1007/978-3-7091-6513-3_12
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7341-1
Online ISBN: 978-3-7091-6513-3
eBook Packages: Springer Book Archive