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Low-grade glioma of the temporal lobe and tumor-related epilepsy in children

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Abstract

Purpose

Low-grade glioma is the most common brain tumor among children and adolescents. When these tumors arise in the temporal lobe, patients frequently present with seizures that are poorly controlled with antiepileptic drugs. Here we summarize the clinical features, pathophysiology, preoperative evaluation, surgical treatment, and outcomes of pediatric patients with low-grade gliomas in the temporal lobe.

Methods

We reviewed the literature on pediatric low-grade gliomas in the temporal lobe, focusing on cohort studies and systematic reviews that described surgical treatment strategies and reported both oncologic and epilepsy outcomes.

Results

The differential diagnoses of pediatric low-grade gliomas in the temporal lobe include ganglioglioma, dysembryoplastic neuroepithelial tumor, desmoplastic infantile ganglioglioma, papillary glioneuronal tumor, pilocytic astrocytoma, pleomorphic xanthoastrocytoma, angiocentric glioma, and polymorphous low-grade neuroepithelial tumor of the young. There is no consensus on the optimal surgical approach for these tumors: lesionectomy alone, or extended lesionectomy with anterior temporal lobectomy, with or without removal of mesial temporal structures. Gross total resection and shorter preoperative duration of epilepsy are strongly associated with favorable seizure outcomes, defined as Engel Class I or Class II, approaching 90% in most series. The risk of surgical complications ranges from 4 to 17%, outweighing the lifetime risks of medically refractory epilepsy.

Conclusion

Pediatric patients with temporal low-grade glioma and tumor-related epilepsy are best managed by a multidisciplinary epilepsy surgery team. Early and appropriate surgery leads to prolonged survival and a greater likelihood of seizure freedom, improving their overall quality of life.

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Data availability

No datasets were generated or analyzed during the current study.

Abbreviations

ATL:

Anterior temporal lobectomy

DIG:

Desmoplastic infantile ganglioglioma

DNET:

Dysembryoplastic neuroepithelial tumor

ECoG:

Electrocorticography

EEG:

Electroencephalography

FCD:

Focal cortical dysplasia

ILAE:

International League Against Epilepsy

LEAT:

Long-term epilepsy associated tumor/low-grade developmental and epilepsy associated brain tumor

LGG:

Low-grade glioma

PGNT:

Papillary glioneuronal tumor

PLNTY:

Polymorphous low-grade neuroepithelial tumor of the young

PXA:

Pleomorphic xanthoastrocytoma

WHO:

World Health Organization

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Acknowledgements

The authors would like to acknowledge the assistance of Dr. John Carlo B. Reyes and Dr. Edwin L. Muñoz of the Department of Laboratories, Philippine General Hospital, for interpreting the pathology slides and providing representative photomicrographs used in this manuscript.

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Authors and Affiliations

  1. Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines

    Ronnie E. Baticulon

  2. Department of Anatomy, College of Medicine, University of the Philippines Manila, Manila, Philippines

    Ronnie E. Baticulon

  3. Division of Neurosurgery, Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand

    Nunthasiri Wittayanakorn

  4. Department of Neurosurgery, The Royal Children’s Hospital, Melbourne, Australia

    Wirginia Maixner

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  1. Ronnie E. Baticulon
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  2. Nunthasiri Wittayanakorn
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  3. Wirginia Maixner
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REB conceptualized the article, performed the literature review, and drafted the manuscript. NW and WM critically reviewed the manuscript and provided supervision. All authors approved the final manuscript.

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Correspondence to Ronnie E. Baticulon.

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Baticulon, R.E., Wittayanakorn, N. & Maixner, W. Low-grade glioma of the temporal lobe and tumor-related epilepsy in children. Childs Nerv Syst (2024). https://doi.org/10.1007/s00381-024-06468-8

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