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Outcome of adult patients with temporal lobe tumours and medically refractory focal epilepsy

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Summary

Background. Tumours are a well-recognized cause of medically intractable epilepsies. Tumours represent the primary pathology in 10%–30% of patients undergoing surgical treatment for chronic epilepsy. This study examines the surgical and epileptological outcome of adults with temporal lobe tumoural epilepsy treated within a comprehensive epilepsy surgery programme.

Methods. Between 1999 and 2004, 99 consecutive patients have been operated for intractable temporal lobe epilepsy (TLE). Among these, 14 adult patients exhibited temporal lobe neoplasms associated with TLE. Every patient underwent a comprehensive presurgical evaluation including video-EEG monitoring, MRI, interictal PET scan, ictal SPECT and neuropsychological testing. Surgical strategies were determined in an interdisciplinary seizure conference and tailored to the findings of the presurgical evaluation. All patients were available for follow up at regular intervals after 3, 6, 12 months and yearly thereafter. Epileptological outcome was classified according to Engel [10] and the ILAE (International League Against Epilepsy)/systems [33].

Findings. The surgical procedures performed were temporal lobe resection in 3 patients, extended lesionectomy in 4 and extended lesionectomy with resection of the temporomesial structures in 7. One patient with an astrocytoma grade III underwent a second and third operation for recurrent disease. Histological results: Astrocytoma 5 patients, ganglioglioma/gangliocytoma 5, oligodendroglioma 2, ependymoma 1 and dysembryoplastic neuroepithelial tumour (DNET) 1. Postoperative follow-up was performed after 12–74 months (mean 31). The outcome according to the Engel classification indicated class IA in 9 patients, class IC in 3, and 1 each in classes IIIA and IVA. Epileptological outcome according to the ILAE classification indicated class 1 (12 patients) and class 4 (2 patients). Surgical mortality was zero and mild permanent neurological deficits due to surgery were seen in 2 patients. Postoperatively 3 patients showed a homonymous quadrantanopia.

Conclusions. Patients with drug resistant epilepsy and temporal lobe tumours should undergo evaluation in dedicated epilepsy surgery programmes.

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References

  • C Arseni IN Petrovici (1971) ArticleTitleEpilepsy in temporal lobe tumours Eur Neurol 5 IssueID4 201–214 Occurrence Handle4331290 Occurrence Handle1:STN:280:DyaE38%2FmtFGqtw%3D%3D

    PubMed  CAS  Google Scholar 

  • J Bampoe M Bernstein (1999) ArticleTitleThe role of surgery on low-grade gliomas J Neuro-Oncol 42 IssueID3 259–269 Occurrence Handle10.1023/A:1006103010109 Occurrence Handle1:STN:280:DyaK1MzmtVCqsw%3D%3D

    Article  CAS  Google Scholar 

  • MS Berger S Ghatan MM Haglund J Dobbins GA Ojemann (1993) ArticleTitleLow-grade gliomas associated with intractable epilepsy: seizure outcome utilising electrocorticography during tumor resection J Neurosurg 79 IssueID1 62–69 Occurrence Handle8315470 Occurrence Handle1:STN:280:DyaK3szgtFOisQ%3D%3D

    PubMed  CAS  Google Scholar 

  • JW Britton GD Cascino FW Sharbrough PJ Kelly (1994) ArticleTitleLow-grade glial neoplasms and intractable partial epilepsy: efficacy of surgical treatment Epilepsia 35 IssueID6 1130–1135 Occurrence Handle7988500 Occurrence Handle10.1111/j.1528-1157.1994.tb01778.x Occurrence Handle1:STN:280:DyaK2M%2FotVWrtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • CJ Bruton (1988) The neuropathology of temporal lobe epilepsy Institute of Psychiatry, Oxford University Press Oxford 74–75

    Google Scholar 

  • O Cataltepe G Üzide Turanli D Ilek Yalnizoglu M Topcu N Akalan (2005) ArticleTitleSurgical management of temporal lobe tumour-related epilepsy in children J Neurosurg 102 IssueIDSuppl 3 280–287 Occurrence Handle15881751

    PubMed  Google Scholar 

  • GD Cascino (1990) ArticleTitleEpilepsy and brain tumours: implications for treatment Epilepsia 31 IssueIDSuppl 3 37–44 Occurrence Handle10.1111/j.1528-1157.1990.tb05858.x

    Article  Google Scholar 

  • GD Cascino PJ Kelly FW Sharbrough JF Hulihan KA Hirschhorn MR Trenerry (1992) ArticleTitleLong-term follow-up of stereotactic lesionectomy in partial epilepsy: predictive factors and electroencephalographic results Epilepsia 33 639–644 Occurrence Handle1628577 Occurrence Handle10.1111/j.1528-1157.1992.tb02340.x Occurrence Handle1:STN:280:DyaK38zjtFGitQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • LM DeAngelis (2001) ArticleTitleBrain tumours N Engl J Med 344 IssueID2 114–123 Occurrence Handle11150363 Occurrence Handle10.1056/NEJM200101113440207 Occurrence Handle1:STN:280:DC%2BD3M7ksVWjtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • J Engel SuffixJr (1993) Outcome with respect to epileptic seizures J Engel SuffixJr (Eds) Surgical treatment of the epilepsies Raven Press New York 609–621

    Google Scholar 

  • I Fried JH Kim DD Spencer (1994) ArticleTitleLimbic and neocortical gliomas associated with intractable seizures: a distinct clinicopathological group Neurosurgery 34 IssueID5 815–824 Occurrence Handle8052378 Occurrence Handle10.1097/00006123-199405000-00005 Occurrence Handle1:STN:280:DyaK2czivFalsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • MJ Hennessy RD Elwes M Honavar S Rabe-Hesketh CD Binnie CE Polkey (2001) ArticleTitlePredictors of outcome and pathological considerations in the surgical treatment of intractable epilepsy associated with temporal lobe lesions J Neurol Neurosurg Psychiatry 70 IssueID4 450–458 Occurrence Handle11254766 Occurrence Handle10.1136/jnnp.70.4.450 Occurrence Handle1:STN:280:DC%2BD3M3os1KksQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • Hess R (1970) Die epileptogenen Hirntumoren. In: Niedermayr E (ed) Epilepsy. Mod Probl Pharmacopsychiat 4: 200–231

  • R Jooma HS Yeh MD Privitera M Gartner (1995) ArticleTitleLesionectomy versus electrophysiologically guided resection for temporal lobe tumours manifesting with complex partial seizures J Neurosurg 83 231–236 Occurrence Handle7616267 Occurrence Handle1:STN:280:DyaK2MzktFentA%3D%3D

    PubMed  CAS  Google Scholar 

  • CL Jorge SK Nagahashi-Marie CC Pedreira S Rosemberg RM Valerio KD Valente EM Yacubian (2000) ArticleTitleClinical characteristics and surgical outcome of patients with temporal lobe tumours and epilepsy Arq Neuropsiquiatr 58 IssueID4 1002–1008 Occurrence Handle11105064 Occurrence Handle1:STN:280:DC%2BD3M%2FovFGqug%3D%3D

    PubMed  CAS  Google Scholar 

  • M Klein NH Engelberts HM van der Ploeg DG Kasteleijn-Nolst Trenité NK Aaronson MJ Taphoorn H Baaijen WP Vandertop M Muller TJ Postma JJ Heimans (2003) ArticleTitleEpilepsy in low-grade gliomas: the impact on cognitive function and quality of life Ann Neurol 54 IssueID4 514–520 Occurrence Handle14520665 Occurrence Handle10.1002/ana.10712

    Article  PubMed  Google Scholar 

  • P Kwan MJ Brodie (2000) ArticleTitleEarly identification of refractory epilepsy N Engel J Med 342 IssueID5 314–319 Occurrence Handle10.1056/NEJM200002033420503 Occurrence Handle1:STN:280:DC%2BD3c7gs1KqtQ%3D%3D

    Article  CAS  Google Scholar 

  • C Luyken I Blümcke R Flimmers H Urbach OD Wiestler J Schramm (2004) ArticleTitleSupratentorial gangliogliomas: histopathologic grading and tumor recurrence in 184 patients with a median follow-up of 8 years Cancer 101 IssueID1 146–55 Occurrence Handle15222000 Occurrence Handle10.1002/cncr.20332

    Article  PubMed  Google Scholar 

  • AM McIntosh SJ Wilson SF Berkovic (2001) ArticleTitleSeizure outcome after temporal lobectomy: current research practice and findings Epilepsia 42 IssueID10 1288–1307 Occurrence Handle11737164 Occurrence Handle10.1046/j.1528-1157.2001.02001.x Occurrence Handle1:STN:280:DC%2BD3MnptlSktQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JL Moore GD Cascino MR Trenerry (1992) ArticleTitleA comparative study of lesion resection with corcticectomy with stereotactic lesionectomy in patients with temporal mass lesional epilepsy Epilepsia 33 IssueIDSuppl 3 96

    Google Scholar 

  • HH Morris ML Estes R Gilmore PC Van Ness GH Barnett J Turnbull (1993) ArticleTitleChronic intractable epilepsy as the only symptom of primary brain tumour Epilepsia 34 IssueID6 1038–1043 Occurrence Handle8243354 Occurrence Handle10.1111/j.1528-1157.1993.tb02131.x Occurrence Handle1:STN:280:DyaK2c%2Fmt1Oisg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • KH Plate HG Wieser MG Yasargil OD Wiestler (1993) ArticleTitleNeuropathological findings in 224 patients with temporal lobe epilepsy Acta neuropathol 86 IssueID5 433–438 Occurrence Handle8310793 Occurrence Handle10.1007/BF00228577 Occurrence Handle1:STN:280:DyaK2c7ksVeitg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • VV Radhakrishnan MB Rao K Radhakrishnan SV Thomas DS Nayak B Santoshkumar E Joseph B Raghunath (1999) ArticleTitlePathology of temporal lobe epilepsy: an analysis of 100 consecutive surgical specimens from patients with medically refractory epilepsy Neurol India 47 IssueID3 196–201 Occurrence Handle10514578 Occurrence Handle1:STN:280:DyaK1MvksFyqsg%3D%3D

    PubMed  CAS  Google Scholar 

  • T Rasmussen (1975) ArticleTitleSurgery of epilepsy associated with brain tumours Adv Neurol 8 227–239 Occurrence Handle164107 Occurrence Handle1:STN:280:DyaE2M7isFGisg%3D%3D

    PubMed  CAS  Google Scholar 

  • LD Recht R Lew TW Smith (1992) ArticleTitleSuspected low-grade glioma: is deferring treatment safe? Ann Neurol 31 IssueID4 431–436 Occurrence Handle1586143 Occurrence Handle10.1002/ana.410310413 Occurrence Handle1:STN:280:DyaK383msVOjtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JH Rees (2002) ArticleTitleLow-grade gliomas in adults Curr Opin Neurol 15 IssueID6 657–661 Occurrence Handle12447102 Occurrence Handle10.1097/00019052-200212000-00001

    Article  PubMed  Google Scholar 

  • S Panda VV Radhakrishnan K Radhakrishnan RM Rao SP Sankara (2005) ArticleTitleElectro-clinical characteristics and postoperative outcome of medically refractory tumoural temporal lobe epilepsy Neurol India 53 IssueID1 66–71 Occurrence Handle15805659 Occurrence Handle10.4103/0028-3886.15061

    Article  PubMed  Google Scholar 

  • A Sasaki J Hirato Y Nakazato M Tamura H Kadowaki (1996) ArticleTitleRecurrent anaplastic ganglioglioma: pathological characterization of tumour cells. Case report J Neurosurg 84 1055–1059 Occurrence Handle8847572 Occurrence Handle1:STN:280:DyaK283jslymsA%3D%3D Occurrence Handle10.3171/jns.1996.84.6.1055

    Article  PubMed  CAS  Google Scholar 

  • B Schaller SJ Rüegg (2003) ArticleTitleBrain tumour and seizures: pathophysiology and its implications for treatment revisited Epilepsia 44 IssueID9 1223–1232 Occurrence Handle12919395 Occurrence Handle10.1046/j.1528-1157.2003.05203.x

    Article  PubMed  Google Scholar 

  • DD Spencer (1992) Strategies for focal resection in medically intractable epilepsy WH Theodore (Eds) Surgical treatment of epilepsy Elsevier Amsterdam 157–168

    Google Scholar 

  • DD Spencer SS Spencer RH Mattson PD Williamson (1984) ArticleTitleIntracerebral masses in patients with intractable partial epilepsy Neurology 34 IssueID4 432–436 Occurrence Handle6422323 Occurrence Handle1:STN:280:DyaL2c7kt1Kktw%3D%3D

    PubMed  CAS  Google Scholar 

  • NM Wetjen K Radhakrishnan AA Cohen-Gadol GD Cascino (2004) Resective surgery of neoplastic lesions for epilepsy SD Shorvon E Perucca DR Fish WE Dodson (Eds) The treatment of epilepsy Blackwell Science Oxford 728–741

    Google Scholar 

  • HG Wieser WT Blume D Fish E Goldensohn A Hufnagel D King MR Sperling H Luders TA Pedley (2001) ArticleTitleILAE Commission report: proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery Epilepsia 42 IssueID2 282–286 Occurrence Handle11240604 Occurrence Handle10.1046/j.1528-1157.2001.4220282.x Occurrence Handle1:STN:280:DC%2BD3M7osV2gsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • HK Wolf MG Campos J Zentner A Hufnagel J Schramm CE Elger OD Wiestler (1993) ArticleTitleSurgical pathology of temporal lobe epilepsy. Experience with 216 cases J Neuropathol 52 IssueID5 499–506 Occurrence Handle1:STN:280:DyaK3szmslGhsw%3D%3D Occurrence Handle10.1097/00005072-199309000-00008

    Article  CAS  Google Scholar 

  • MM Zaatreh KS Firlik DD Spencer SS Spencer (2003) ArticleTitleTemporal lobe tumoural epilepsy: characteristics and predictors of surgical outcome Neurology 61 IssueID5 636–641 Occurrence Handle12963754

    PubMed  Google Scholar 

  • J Zentner A Hufnagel HK Wolf B Ostertun E Behrens MG Campos CE Elger OD Wiestler J Schramm (1997) ArticleTitleSurgical treatment of neoplasms associated with medically intractable epilepsy Neurosurgery 41 IssueID2 378–387 Occurrence Handle9257305 Occurrence Handle10.1097/00006123-199708000-00008 Occurrence Handle1:STN:280:DyaK2svgtFGguw%3D%3D

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Clinical Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria

    R. Bauer, C. Unterhofer & M. Ortler

  2. Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

    J. Dobesberger, I. Unterberger, G. Walser, G. Bauer & E. Trinka

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  1. R. Bauer
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  2. J. Dobesberger
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  3. C. Unterhofer
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  4. I. Unterberger
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  5. G. Walser
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  6. G. Bauer
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  7. E. Trinka
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  8. M. Ortler
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Bauer, R., Dobesberger, J., Unterhofer, C. et al. Outcome of adult patients with temporal lobe tumours and medically refractory focal epilepsy. Acta Neurochir (Wien) 149, 1211–1217 (2007). https://doi.org/10.1007/s00701-007-1366-z

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  • DOI: https://doi.org/10.1007/s00701-007-1366-z

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