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Brain tumour related epilepsy

Hans Holthausen, Ingmar Blümcke
Brain tumours are an ever-challenging issue in neurology and related medical disciplines. This applies in particular to brain tumours associated with childhood-onset epilepsies, in which seizures are the presenting and only neurological symptom, as our current understanding of the biology and clinical behaviour of an individual tumour is far from being evidence-based. Prospective and randomized clinical trials are lacking in the field of epilepsy-associated tumours and a review of the current literature evokes more questions than provides answers...
September 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
Andrew R Tee, Julian R Sampson, Deb K Pal, Joseph M Bateman
Understanding the development and function of the nervous system is one of the foremost aims of current biomedical research. The nervous system is generated during a relatively short period of intense neurogenesis that is orchestrated by a number of key molecular signalling pathways. Even subtle defects in the activity of these molecules can have serious repercussions resulting in neurological, neurodevelopmental and neurocognitive problems including epilepsy, intellectual disability and autism. Tuberous sclerosis complex (TSC) is a monogenic disease characterised by these problems and by the formation of benign tumours in multiple organs, including the brain...
April 2016: Seminars in Cell & Developmental Biology
Timo Kirschstein, Rüdiger Köhling
Brain tumours cause a sizeable proportion of epilepsies in adulthood, and actually can be etiologically responsible also for childhood epilepsies. Conversely, seizures are often first clinical signs of a brain tumour. Nevertheless, several issues of brain-tumour associated seizures and epilepsies are far from understood, or clarified regarding clinical consensus. These include both the specific mechanisms of epileptogenesis related to different tumour types, the possible relationship between malignancy and seizure emergence, the interaction between tumour mass and surrounding neuronal networks, and - not least - the best treatment options depending on different tumour types...
February 15, 2016: Journal of Neuroscience Methods
Riki Matsumoto, Nobuhiro Mikuni, Keiko Tanaka, Kiyohide Usami, Kenjiro Fukao, Takeharu Kunieda, Yukitoshi Takahashi, Susumu Miyamoto, Hidenao Fukuyama, Ryosuke Takahashi, Akio Ikeda
"Formes frustes" of encephalopathy associated with anti-NMDAR antibody have been recently described in cases of chronic epilepsy. We report a young woman with a parietal lesion and anti-NMDAR antibody who acquired bilateral, secondary epileptogenesis in the temporal lobes within a period as short as six years. Removal of the primary epileptogenic lesion of oligoastrocytoma in the right parietal lobe resulted in seizure freedom, disappearance of secondary foci, and substantial decrease of the antibody titre...
March 2015: Epileptic Disorders: International Epilepsy Journal with Videotape
W Fröscher, T Kirschstein, J Rösche
The lifetime risk of patients with brain tumours to have focal epileptic seizures is 20-80%. Based on current evidence the management of tumour-related seizures does not differ substantially from that applied to epilepsies from other aetiologies. Therefore, the choice of an anticonvulsant is based, above all, on tolerability and pharmacokinetic interactions with chemotherapeutic drugs. Levetiracetam is recommended by many authors as first-line therapy in brain tumour-related epilepsy; this corresponds with the recommendation of the German guidelines on the treatment of focal seizures of any aetiology...
December 2014: Fortschritte der Neurologie-Psychiatrie
Wiesława Grajkowska, Ewa Matyja, Paweł Daszkiewicz, Marcin Roszkowski, Jarosław Peregud-Pogorzelski, Elzbieta Jurkiewicz
Angiocentric glioma is a low-grade tumour that occurs in children and young adults with a long-standing epilepsy. The typical histopathological features of this tumour is the presence of spindle-shaped cells, radially oriented around the cortical blood vessels. We present two teenage cases of the angiocentric variant of glioma: 1) a 15-year-old girl with a chronic and intractable partial epilepsy with cystic tumour located in the right temporal lobe and 2) a 14-year-old boy with intractable seizures and an extensive cortical lesion in the left parieto-occipital area...
2014: Folia Neuropathologica
K Nielsen, H J Scheffer, J M Vieveen, A A J M van Tilborg, S Meijer, C van Kuijk, M P van den Tol, M R Meijerink, R A Bouwman
BACKGROUND: Irreversible electroporation (IRE) is a novel tumour ablation technique involving repetitive application of electrical energy around a tumour. The use of pulsed electrical gradients carries a risk of cardiac arrhythmias, severe muscle contractions, and seizures. We aimed to identify IRE-related risks and the appropriate precautions for anaesthetic management. METHODS: All patients who were treated with IRE were prospectively included. Exclusion criteria were arrhythmias, congestive heart failure, active coronary artery disease, and epilepsy...
December 2014: British Journal of Anaesthesia
Johan A F Koekkoek, Melissa Kerkhof, Linda Dirven, Jan J Heimans, Tjeerd J Postma, Maaike J Vos, Jacoline E C Bromberg, Martin J van den Bent, Jaap C Reijneveld, Martin J B Taphoorn
BACKGROUND: Epilepsy is common in patients with a glioma. Antiepileptic drugs (AEDs) are the mainstay of epilepsy treatment, but may cause side effects and may negatively impact neurocognitive functioning and quality of life. Besides antiepileptic drugs, anti-tumour treatment, which currently consists of surgery, radiotherapy and/or chemotherapy, may contribute to seizure control as well. In glioma patients with seizure freedom after anti-tumour therapy the question emerges whether AEDs should be continued, particularly in the case where anti-tumour treatment has been successful...
2014: BMC Neurology
Ashish Harish Shah, Catherine E Gordon, Amade Bregy, Nirav Shah, Ricardo Jorge Komotar
It is generally well known that medial temporal lobe resections have been associated with a variety of postoperative neuropsychiatric disturbances. Most of the neurosurgical literature on psychiatric disturbances after a temporal lobectomy concern patients with a strong history of epilepsy; however, relatively few articles have been reported due to a mesial temporal lobectomy following tumour removal. We report the case of a patient who underwent a gross total resection of a malignant astrocytoma in the temporal lobe who developed transient psychosis...
2014: BMJ Case Reports
C J Stam, P Tewarie, E Van Dellen, E C W van Straaten, A Hillebrand, P Van Mieghem
In recent years there has been a shift in focus from the study of local, mostly task-related activation to the exploration of the organization and functioning of large-scale structural and functional complex brain networks. Progress in the interdisciplinary field of modern network science has introduced many new concepts, analytical tools and models which allow a systematic interpretation of multivariate data obtained from structural and functional MRI, EEG and MEG. However, progress in this field has been hampered by the absence of a simple, unbiased method to represent the essential features of brain networks, and to compare these across different conditions, behavioural states and neuropsychiatric/neurological diseases...
June 2014: International Journal of Psychophysiology
Karolina Kołosowska, Piotr Maciejak, Janusz Szyndler, Danuta Turzyńska, Alicja Sobolewska, Adam Płaźnik
Because the contribution of inflammatory mediators to seizure disorders is unclear, we investigated the changes in the expression of interleukin-1β (IL-β) and its receptor - IL-1 receptor type 1 (IL-1R1), tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the rat hippocampus at different stages of pentylenetetrazole (PTZ)-induced kindling. The occurrence and progressive development of seizures were induced by repeated systemic administration of PTZ, a non-competitive antagonist of the γ-aminobutyric acid type A (GABAA) receptor at a subconvulsive dose of 30 mg/kg...
May 15, 2014: European Journal of Pharmacology
Jolandi van Heerden, Patricia M Desmond, Pramit M Phal
In clinical practice, functional magnetic resonance imaging (fMRI) is a valuable non-invasive tool particularly during preoperative work-up of brain tumour and epilepsy patients. In this pictorial essay, we review expected areas of eloquent cortical activation during the four major clinical paradigms, discuss pitfalls related to fMRI and look at clinical examples where fMRI was particularly valuable in preoperative planning.
2014: Journal of Medical Imaging and Radiation Oncology
Eugen Trinka, Francesco Brigo
PURPOSE OF REVIEW: Preclinical research in epileptology has been very successful in developing antiseizure drugs (ASDs). Several preclinical proof-of-concept studies have also provided evidence for positive treatment effects of some antiepileptogenic drugs to prevent the development of epilepsy. Disappointingly, all human antiepileptogenesis trials to prevent epilepsy after brain insults have failed, because of several reasons. RECENT FINDINGS: None of the currently available ASDs have been shown to prevent epilepsy after stroke, traumatic brain injury, or in brain tumours...
April 2014: Current Opinion in Neurology
Marta Maschio, Loredana Dinapoli, Francesca Sperati, Andrea Pace, Alessandra Fabi, Antonello Vidiri, Alfredo Pompili, Carmine Maria Carapella
OBJECTIVE: An open pilot study to evaluate the effect of pregabalin (PGB) as add-on therapy on seizure control, quality of life, and anxiety in patients with brain tumour-related epilepsy (BTRE). MATERIALS AND METHODS: We recruited 25 consecutive patients with BTRE and uncontrolled seizures. At baseline and during follow-up, patients underwent a complete physical and neurological examination and were evaluated using the QOLIE 31P (V2), EORTC QLQ C30, Adverse Events Profile, and Hamilton Anxiety Rating Scale (HAM-A)...
December 2012: Epileptic Disorders: International Epilepsy Journal with Videotape
Sam Amin, Michael Carter, Richard J Edwards, Ian Pople, Kristian Aquilina, Jane Merrifield, John P Osborne, Finbar J K O'Callaghan
OBJECTIVES: The indications for surgery and outcomes of patients who underwent surgical removal of subependymal giant cell astrocytomas (SEGAs) in our institution between 2000 and 2011 were reviewed. METHODS: We reviewed the clinical details of 16 patients with a diagnosis of Tuberous Sclerosis Complex (TSC) who underwent surgery for SEGA in Bristol since 2000. We collected information on age, sex, epilepsy history and cognitive status. We reviewed the indications for surgery, age at surgery, surgical approach, and the size and location of the lesions...
January 2013: European Journal of Paediatric Neurology: EJPN
Angelo Carneiro, Sofia Pina, Bruno Moreira
UNLABELLED: Arterial spin labelling (ASL) is a MR perfusion technique that uses protons from water molecules of the arterial blood as an endogenous tracer. It is fast, non-invasive and does not require gadolinium administration. Due to the increasing robustness of the results, it is becoming an important clinical tool.In this article we present our initial experience with ASL, highlighting some technical aspects, the main clinical applications, some achieved results and most important difficulties...
2012: Acta Médica Portuguesa
Bertil Rydenhag, Roland Flink, Kristina Malmgren
PURPOSE: Seizure outcome after epilepsy surgery is to an important extent related to underlying aetiology. In this study of patients who underwent epilepsy surgery with a lesional aetiology in Sweden 1990-2004, the aim was to investigate seizure outcome and prognostic factors. METHODS: All patients operated on during the time period with a histopathological diagnosis of an epileptogenic tumour (ganglioglioma (GGL), dysembryoblastic neuroepithelial tumour (DNET) and low grade astrocytoma (AST)) or a cavernous haemangioma (CAH) were identified in the population based Swedish National Epilepsy Surgery Register...
January 2013: Journal of Neurology, Neurosurgery, and Psychiatry
Michael Weller, Roger Stupp, Wolfgang Wick
The lifetime risk of having epileptic seizures is profoundly increased in patients with cancer: about 20% of all patients with systemic cancer may develop brain metastases. These patients and those with primary brain tumours have a lifetime risk of epilepsy of 20-80%. Moreover, exposure to chemotherapy or radiotherapy to the brain, cancer-related metabolic disturbances, stroke, and infection can provoke seizures. The management of epilepsy in patients with cancer includes diagnosis and treatment of the underlying cerebral pathological changes, secondary prophylaxis with antiepileptic drugs, and limiting of the effect of epilepsy and its treatment on the efficacy and tolerability of anticancer treatments, cognitive function, and quality of life...
September 2012: Lancet Oncology
Luigi Zuliani, Francesc Graus, Bruno Giometto, Christian Bien, Angela Vincent
The concept of antibody mediated CNS disorders is relatively recent. The classical CNS paraneoplastic neurological syndromes are thought to be T cell mediated, and the onconeural antibodies merely biomarkers for the presence of the tumour. Thus it was thought that antibodies rarely, if ever, cause CNS disease. Over the past 10 years, identification of autoimmune forms of encephalitis with antibodies against neuronal surface antigens, particularly the voltage gated potassium channel complex proteins or the glutamate N-methyl-D-aspartate receptor, have shown that CNS disorders, often without associated tumours, can be antibody mediated and benefit from immunomodulatory therapies...
June 2012: Journal of Neurology, Neurosurgery, and Psychiatry
Marjolein de Groot, Jaap C Reijneveld, Eleonora Aronica, Jan J Heimans
Brain tumours frequently cause epileptic seizures. Medical antiepileptic treatment is often met with limited success. Pharmacoresistance, drug interactions and adverse events are common problems during treatment with antiepileptic drugs. The unpredictability of epileptic seizures and the treatment-related problems deeply affect the quality of life of patients with a brain tumour. In this review, we focus on both clinical and basic aspects of possible mechanisms in epileptogenesis in patients with a brain tumour...
April 2012: Brain: a Journal of Neurology
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