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Epilepsy surgery; glioma

Matthew T Brown, Frederick A Boop
INTRODUCTION: Pediatric low-grade tumors are found in roughly 1-3 % of patients with childhood epilepsy; seizures associated with these tumors are often medically refractory and often present a significant morbidity, greater than the presence of the tumor itself. DISCUSSION: The unique morbidity of the seizures often requires an epilepsy surgical approach over a standard oncologic resection to achieve a reduction in morbidity for the child. Multiple quality-of-life studies have shown that unless a patient is seizure-free, they remain disabled throughout their life; the best way to achieve this in our patient population is with a multidisciplinary team approach with treatment goals focusing primarily on the epilepsy...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Alvaro Lassaletta, Michal Zapotocky, Eric Bouffet, Cynthia Hawkins, Uri Tabori
Hemispheric low-grade gliomas account for the second most common location in pediatric low-grade gliomas (PLGGs) after the cerebellum. The pathological spectrum includes gangliogliomas, dysembryoplastic neuroepithelial tumors (DNETs), diffuse astrocytomas, pilocytic astrocytomas, and pleomorphic xanthoastrocytomas (PXAs), among others. Clinically, hemispheric PLGGs represent a well-recognized cause of intractable epilepsy in children and adolescents. With an excellent long-term outcome, surgery remains the cornerstone and patients with gross total resection typically do not need any further therapies...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Edward K Avila, Marc Chamberlain, David Schiff, Jaap C Reijneveld, Terri S Armstrong, Roberta Ruda, Patrick Y Wen, Michael Weller, Johan A F Koekkoek, Sandeep Mittal, Yoshiki Arakawa, Ali Choucair, Jorge Gonzalez-Martinez, David R MacDonald, Ryo Nishikawa, Aashit Shah, Charles J Vecht, Paula Warren, Martin J van den Bent, Lisa M DeAngelis
Patients with low-grade glioma frequently have brain tumor-related epilepsy, which is more common than in patients with high-grade glioma. Treatment for tumor-associated epilepsy usually comprises a combination of surgery, anti-epileptic drugs (AEDs), chemotherapy, and radiotherapy. Response to tumor-directed treatment is measured primarily by overall survival and progression-free survival. However, seizure frequency has been observed to respond to tumor-directed treatment with chemotherapy or radiotherapy...
September 20, 2016: Neuro-oncology
Keisuke Sato, Masafumi Fukuda, Yosuke Sato, Tetsuya Hiraishi, Tetsuro Takao, Yukihiko Fujii
BACKGROUND: Understanding of cortico-cortical activity in eloquent areas intraoperatively is crucial for neurosurgical procedures. Here, we used intraoperative near-infrared spectroscopy (iNIRS) during direct cortical stimulation as a robust tool to better understand the cortico-cortical connectivity in language systems. METHODS: We applied iNIRS to 3 patients who underwent epilepsy surgery due to lesions (cavernous angioma, epidermoid cyst, and low-grade glioma) located in language areas...
September 6, 2016: Neuroscience Letters
Krasimir Minkin, Emanuil Naydenov, Kaloyan Gabrovski, Petia Dimova, Marin Penkov, Rositsa Tanova, Sevdelin Nachev, Kiril Romanski
OBJECTIVE: Successful use of high-dose fluorescein-sodium (20mg/kg) with a standard light microscope for resection of high-grade gliomas, meningiomas, hemangioblastoma and metastases was reported. The principle of brain tumor staining by fluorescein-sodium (Fl-Na) consists in the accumulation of fluorescein in brain tumors with impaired blood-brain barrier. The aim of our study was to investigate for the first time the usefulness of high-dose fluorescein in patients operated on for benign neuroepithelial brain tumors (grade I WHO tumors) with contrast enhancement on magnetic resonance imaging...
October 2016: Clinical Neurology and Neurosurgery
Andrew Neal, Tanya Yuen, Andrew R Bjorksten, Patrick Kwan, Terence J O'Brien, Andrew Morokoff
To examine the impact of glutamate on post-operative seizures and survival in a cohort of patients with grade II to IV supratentorial glioma. A retrospective analysis was performed on 216 patients who underwent surgery for supratentorial gliomas. Primary explanatory variables were peritumoural and/or tumoural glutamate concentrations, glutamate transporter expression (EAAT2 and SXC). Univariate and multivariate survival analysis was performed with primary outcomes of time to first post-operative seizure and overall survival...
September 2016: Journal of Neuro-oncology
Aparna Banerjee Dixit, Jyotirmoy Banerjee, Abuzar Ansari, Manjari Tripathi, Sarat P Chandra
AIM: This study is focused on GABRG2 gene sequence variations in patients with mesial temporal lobe epilepsy (mTLE). The GABAAreceptor is a heteropentameric receptor and alpha-1 beta-2 gamma-2 subunits combination is most abundant and present in almost all regions of the brain. The gamma-2 subunit (GABRG2) gene mutations have been reported in different epilepsy pathologies. In the present study we have looked for GABRG2 gene sequence variations in patients with mTLE. MATERIALS AND METHODS: Twenty patients (12 females and eight males, age 4...
April 2016: Annals of Indian Academy of Neurology
Karine Michaud, Hugues Duffau
Once considered a "no man's land" especially when invaded by a diffuse low grade glioma (DLGG), the insula remains to this day a surgical challenge. Surgery for insular DLGG involves consideration of its hidden location under the potentially eloquent operculae, the proximity to vascular tree and high density of functions not only in the insular cortex but also in the white fiber pathways passing under the insular lobe. The natural history of DLGG and the potential benefits and consequences of the surgical approach also need a close look...
May 9, 2016: Journal of Neuro-oncology
Maysam Alimohamadi, Mohammad Shirani, Reza Shariat Moharari, Ahmad Pour-Rashidi, Mehdi Ketabchi, Mohammadreza Khajavi, Mohamadali Arami, Abbas Amirjamshidi
BACKGROUND: Radical resection of dominant insular gliomas is difficult because of their close vicinity with internal capsule, basal ganglia, and speech centers. Brain mapping techniques can be used to maximize the extent of tumor removal and to minimize postoperative morbidities by precise localization of eloquent cortical and subcortical areas. METHODS: Patients with newly diagnosed gliomas of dominant insula were enrolled. The exclusion criteria were severe cognitive disturbances, communication difficulty, age greater than 75 years, severe obesity, difficult airways for intubation and severe cardiopulmonary diseases...
August 2016: World Neurosurgery
W Langsteger, A Rezaee, W Loidl, H S Geinitz, F Fitz, M Steinmair, G Broinger, L Pallwien-Prettner, M Beheshti, L Imamovic, M Beheshti, G Rendl, D Hackl, O Tsybrovsky, M Steinmair, K Emmanuel, F Moinfar, C Pirich, W Langsteger, A Bytyqi, G Karanikas, M Mayerhöfer, O Koperek, B Niederle, M Hartenbach, T Beyer, K Herrmann, J Czernin, I Rausch, P Rust, M D DiFranco, M Lassen, A Stadlbauer, M E Mayerhöfer, M Hartenbach, M Hacker, T Beyer, K Binzel, R Magnussen, W Wei, M U Knopp, D C Flanigan, C Kaeding, M V Knopp, A Leisser, M Nejabat, M Hartenbach, G Kramer, M Krainer, M Hacker, A Haug, Wencke Lehnert, Karl Schmidt, Sharok Kimiaei, Marcus Bronzel, Andreas Kluge, C L Wright, K Binzel, J Zhang, Evan Wuthrick, Piotr Maniawski, M V Knopp, M Blaickner, E Rados, A Huber, M Dulovits, H Kulkarni, S Wiessalla, C Schuchardt, R P Baum, B Knäusl, D Georg, M Bauer, B Wulkersdorfer, W Wadsak, C Philippe, H Haslacher, M Zeitlinger, O Langer, M Bauer, M Feldmann, R Karch, W Wadsak, M Zeitlinger, M J Koepp, M-C Asselin, E Pataraia, O Langer, M Zeilinger, C Philippe, M Dumanic, F Pichler, J Pilz, M Hacker, W Wadsak, M Mitterhauser, L Nics, B Steiner, M Hacker, M Mitterhauser, W Wadsak, A Traxl, Thomas Wanek, Kushtrim Kryeziu, Severin Mairinger, Johann Stanek, Walter Berger, Claudia Kuntner, Oliver Langer, S Mairinger, T Wanek, A Traxl, M Krohn, J Stanek, T Filip, M Sauberer, C Kuntner, J Pahnke, O Langer, D Svatunek, C Denk, M Wilkovitsch, T Wanek, T Filip, C Kuntner-Hannes, J Fröhlich, H Mikula, C Denk, D Svatunek, T Wanek, S Mairinger, J Stanek, T Filip, J Fröhlich, H Mikula, C Kuntner-Hannes, T Balber, J Singer, J Fazekas, C Rami-Mark, N Berroterán-Infante, E Jensen-Jarolim, W Wadsak, M Hacker, H Viernstein, M Mitterhauser, C Denk, D Svatunek, B Sohr, H Mikula, J Fröhlich, T Wanek, C Kuntner-Hannes, T Filip, S Pfaff, C Philippe, M Mitterhauser, M Hartenbach, M Hacker, W Wadsak, T Wanek, E Halilbasic, M Visentin, S Mairinger, B Stieger, C Kuntner, M Trauner, O Langer, P Lam, M Aistleitner, R Eichinger, C Artner, H Eidherr, C Vraka, A Haug, M Mitterhauser, L Nics, M Hartenbach, M Hacker, W Wadsak, H Kvaternik, R Müller, D Hausberger, C Zink, R M Aigner, U Cossío, M Asensio, A Montes, S Akhtar, Y Te Welscher, R van Nostrum, V Gómez-Vallejo, J Llop, F VandeVyver, T Barclay, N Lippens, M Troch, L Hehenwarter, B Egger, J Holzmannhofer, M Rodrigues-Radischat, C Pirich, N Pötsch, I Rausch, D Wilhelm, M Weber, J Furtner, G Karanikas, A Wöhrer, M Mitterhauser, M Hacker, T Traub-Weidinger, T Cassou-Mounat, S Balogova, V Nataf, M Calzada, V Huchet, K Kerrou, J-Y Devaux, M Mohty, L Garderet, J-N Talbot, S Stanzel, G Pregartner, T Schwarz, V Bjelic-Radisic, B Liegl-Atzwanger, R Aigner, S Stanzel, F Quehenberger, R M Aigner, A Koljević Marković, Milica Janković, V Miler Jerković, M Paskaš, G Pupić, R Džodić, D Popović, M C Fornito, D Familiari, P Koranda, H Polzerová, I Metelková, L Henzlová, R Formánek, E Buriánková, M Kamínek, W H Thomson, C Lewis, W H Thomson, J O'Brien, G James, A Notghi, H Huber, I Stelzmüller, R Wunn, M Mandl, F Fellner, B Lamprecht, M Gabriel, M C Fornito, G Leonardi, W H Thomson, J O'Brien, G James, J Hudzietzová, J Sabol, M Fülöp
A1 68Ga-PSMA PET/CT in staging and restaging of Prostate Cancer Patients: comparative study with 18F-Choline PET/CTW Langsteger, A Rezaee, W Loidl, HS Geinitz, F Fitz, M Steinmair, G Broinger, L Pallwien-Prettner, M BeheshtiA2 F18 Choline PET - CT: an accurate diagnostic tool for the detection of parathyroid adenoma?L Imamovic, M Beheshti, G Rendl, D Hackl, O Tsybrovsky, M Steinmair, K Emmanuel, F Moinfar, C Pirich, W LangstegerA3 [18F]Fluoro-DOPA-PET/CT in the primary diagnosis of medullary thyroid carcinomaA Bytyqi, G Karanikas, M Mayerhöfer, O Koperek, B Niederle, M HartenbachA4 Variations of clinical PET/MR operations: An international survey on the clinical utilization of PET/MRIT Beyer, K Herrmann, J CzerninA5 Standard Dixon-based attenuation correction in combined PET/MRI: Reproducibility and the possibility of Lean body mass estimationI Rausch, P Rust, MD DiFranco, M Lassen, A Stadlbauer, ME Mayerhöfer, M Hartenbach, M Hacker, T BeyerA6 High resolution digital FDG PET/MRI imaging for assessment of ACL graft viabilityK Binzel, R Magnussen, W Wei, MU Knopp, DC Flanigan, C Kaeding, MV KnoppA7 Using pre-existing hematotoxicity as predictor for severe side effects and number of treatment cycles of Xofigo therapyA Leisser, M Nejabat, M Hartenbach, G Kramer, M Krainer, M Hacker, A HaugA8 QDOSE - comprehensive software solution for internal dose assessmentWencke Lehnert, Karl Schmidt, Sharok Kimiaei, Marcus Bronzel, Andreas KlugeA9 Clinical impact of Time-of-Flight on next-generation digital PET imaging of Yttrium-90 radioactivity following liver radioembolizationCL Wright, K Binzel, J Zhang, Evan Wuthrick, Piotr Maniawski, MV KnoppA10 Snakes in patients! Lessons learned from programming active contours for automated organ segmentationM Blaickner, E Rados, A Huber, M Dulovits, H Kulkarni, S Wiessalla, C Schuchardt, RP Baum, B Knäusl, D GeorgA11 Influence of a genetic polymorphism on brain uptake of the dual ABCB1/ABCG2 substrate [11C]tariquidarM Bauer, B Wulkersdorfer, W Wadsak, C Philippe, H Haslacher, M Zeitlinger, O LangerA12 Outcome prediction of temporal lobe epilepsy surgery from P-glycoprotein activity...
April 2016: EJNMMI Research
F Fang, Y X Lin, D Z Kang, F Wang, X F Huang, L H Yu, Z Y Lin
OBJECTIVE: To explore the relevant factors associated with the surgical efficacy and prognosis of seizures in patients with low-grade glioma (LGG). METHODS: The clinical cases of seizures in patients with LGG admitted to our department were retrospectively collected from January 2010 to December 2014. A total of 45 cases were studied to analyze the relevant factors associated with the surgical efficacy and prognosis. RESULTS: During a follow-up period of 1 to 5 years after surgery, Engel classⅠ to Ⅱ were achieved in 36 patients (80%) and Engel class Ⅲ to Ⅳ in 9 cases (20%)...
April 5, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Karl Roessler, Andrea Hofmann, Bjoern Sommer, Peter Grummich, Roland Coras, Burkard Sebastian Kasper, Hajo M Hamer, Ingmar Blumcke, Hermann Stefan, Christopher Nimsky, Michael Buchfelder
OBJECTIVE: Intraoperative overestimation of resection volume in epilepsy surgery is a well-known problem that can lead to an unfavorable seizure outcome. Intraoperative MRI (iMRI) combined with neuronavigation may help surgeons avoid this pitfall and facilitate visualization and targeting of sometimes ill-defined heterogeneous lesions or epileptogenic zones and may increase the number of complete resections and improve seizure outcome. METHODS: To investigate this hypothesis, the authors conducted a retrospective clinical study of consecutive surgical procedures performed during a 10-year period for epilepsy in which they used neuronavigation combined with iMRI and functional imaging (functional MRI for speech and motor areas; diffusion tensor imaging for pyramidal, speech, and visual tracts; and magnetoencephalography and electrocorticography for spike detection)...
March 2016: Neurosurgical Focus
Satoshi Maesawa, Epifanio Bagarinao, Masazumi Fujii, Miyako Futamura, Toshihiko Wakabayashi
Cutting-edge neuroimaging technologies can facilitate preoperative evaluation in various neurosurgical settings. Surgery for gliomas and epilepsy requires precise localization for resection due to the need to preserve (or perhaps improve) higher cognitive functions. Accordingly, a hodological approach should be taken that considers subcortical networks as well as cortical functions within various functional domains. Resting state functional magnetic resonance imaging (fMRI) has the potential to provide new insights that are valuable for this approach...
2016: Neurologia Medico-chirurgica
Leonel Ampie, Winward Choy, Joseph D DiDomenico, Jonathan B Lamano, Christopher Kazu Williams, Kartik Kesavabhotla, Qinwen Mao, Orin Bloch
Angiocentric gliomas (AG) are exceedingly rare low-grade neoplasms which often present in the form of intractable epilepsy within younger patients. The current study extensively reviews all reported cases which were pathologically verified as AG in the literature to analyze clinical attributes and surgical outcomes of this neoplasm. There were 88 patients with AG reported in the literature consisting mostly of pediatric cases. The sex distribution consisted of 45 males and 36 females with the remaining seven cases not documenting sex...
June 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
M Hirsch, V A Coenen, D H Heiland, N Lützen, O Staszewski, A Schulze-Bonhage
BACKGROUND: Among the tumors associated with chronic epilepsy, dysembryoplastic neuroepithelial tumor and ganglioglioma are the most common besides angiocentric glioma, pleomorphic xanthoastrocytoma and pilocytic astrocytoma. These tumors are usually considered as being benign. OBJECTIVE: To determine the best conservative and surgical treatment of tumors associated with epilepsy. MATERIAL AND METHODS: This article presents case reports of malignant transformation of a dysembryoplastic neuroepithelial tumor and of a tumor initially diagnosed as a ganglioglioma based on magnetic resonance imaging (MRI) criteria...
April 2016: Der Nervenarzt
Liu Yang, Zenghui Liu, Ronghua Wu, Qi Yao, Zhikai Gu, Mei Liu
C-X-C chemokine receptor 2 (CXCR2), a member of the G-protein-coupled receptor family, is an interleukin-8 receptor and results in the activation of neutrophils. To date, CXCR2 has been identified with many cell events, including inflammation, neovascularization, metastasis, and cell carcinogenesis. This study aimed to investigate alterations in the expression of CXCR2 in patients with brain gliomas and relationships with pathological grades and clinicopathological characteristics. Brain tissue specimens from 60 patients with glioma and 15 patients undergoing surgery for epilepsy (controls) were detected using streptavidin-perosidase immunohistochemistry...
2015: OncoTargets and Therapy
Hugues Duffau
BACKGROUND: Total or subtotal surgical resection of WHO grade II glioma (diffuse low-grade glioma, DLGG) can significantly increase survival. Moreover, a supratotal resection, i.e., an extended resection with a margin beyond MR imaging abnormalities, could decrease the risk of malignant transformation. Here, the goal is to analyze the long-term functional and oncological outcomes following supratotal resection for DLGG. METHODS: Sixteen consecutive patients who underwent supratotal resection for a DLGG with a minimum follow-up of 8 years after surgery were included...
January 2016: Acta Neurochirurgica
Melissa Kerkhof, Christa Benit, Alberto Duran-Pena, Charles J Vecht
Epilepsy develops in more than 70-90% of oligodendroglial tumors and represents a favorable indicator for long-term survival if present as the first clinical sign. Presence of IDH1 mutation is frequently associated with seizures in oligodendrogliomas, next to alterations of glutamate and GABA metabolism in the origin of glioma-associated epilepsy. Treatment by surgery or radiotherapy results in seizure freedom in about two-thirds of patients, and chemotherapy to a seizure reduction in about 50%. Symptomatic anticonvulsive therapy with levetiracetam and valproic acid as monotherapy are both evidence-based drugs for the partial epilepsies, and their effective use in brain tumors is supported by a large amount of additional data...
2015: CNS Oncology
Lucas Crociati Meguins, Rodrigo Antônio Rocha da Cruz Adry, Sebastião Carlos da Silva Júnior, Carlos Umberto Pereira, Jean Gonçalves de Oliveira, Dionei Freitas de Morais, Gerardo Maria de Araújo Filho, Lúcia Helena Neves Marques
Objective To present a surgical series of patients with low grade temporal gliomas causing intractable epilepsy, focusing on long-term seizure outcome.Method A retrospective study was conducted with patients with temporal low-grade gliomas (LGG).Results Sixty five patients with were operated in our institution. Males were more affected than females and the mean age at surgery was 32.3 ± 8.4 (9-68 years). The mean age at seizure onset was 25.7 ± 9.2 (11-66 years). Seizure outcome was classified according with Engel classification...
October 6, 2015: Arquivos de Neuro-psiquiatria
F Sala, A Coppola, V Tramontano, M Babini, G Pinna
Intraoperative neurophysiology (ION) is the gold standard to map and monitor brain functions during supratentorial surgery in critical areas. This is of great value for the surgery of brain gliomas in adults, but the same ION techniques can be used in the pediatric population with respect to both epilepsy and brain tumor surgery. While the principles of most ION techniques are the same for adults and children, the developing nervous system has peculiar characteristics in terms of anatomical and physiological maturation of afferent and efferent pathways within the brain and the spinal cord...
December 2015: Journal of Neurosurgical Sciences
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