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Updated: Jul 6, 2026
Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
MRI of long-term epilepsy-associated tumors
1Department of Radiology/Neuroradiology, University of Bonn Medical Center, Bonn, Germany. urbach@uni-bonn.de
Abstract:
In 20 to 30% of patients with long-term drug-resistant epilepsy neuroepithelial tumors, usually glioneuronal tumors are found. Gangliogliomas and dysembryoplastic neuroepithelial tumors (DNTs) are well characterized, both clinically and on MRI. Both tumor types are located in the cortex or in the cortex and subcortical white matter, gangliogliomas most commonly in the mesial temporal lobe ("around the collateral sulcus"). Both tumor types have typical imaging features, and from both, location and imaging features, they can be usually distinguished from glial tumors. This distinction is important since more than 70% of patients with drug resistant temporal lobe epilepsy caused by gangliogliomas and DNTs get seizure free following extended lesionectomy.
Insights
Neuroepithelial tumors like gangliogliomas and dysembryoplastic neuroepithelial tumors (DNTs) are found in 20-30% of epilepsy patients. Surgical removal of these tumors can lead to seizure freedom in over 70% of cases.
Area of Science:
- Neurology
- Neurosurgery
- Oncology
Background:
- Drug-resistant epilepsy affects 20-30% of patients with neuroepithelial tumors, primarily glioneuronal types.
- Gangliogliomas and dysembryoplastic neuroepithelial tumors (DNTs) are common causes, characterized by distinct clinical and MRI findings.
- These tumors typically occur in the cortex or subcortical white matter, with gangliogliomas frequently found in the mesial temporal lobe.
Purpose of the Study:
- To highlight the diagnostic features of gangliogliomas and DNTs.
- To differentiate these tumors from other glial tumors based on location and imaging.
- To emphasize the importance of accurate diagnosis for surgical intervention.
Main Methods:
- Review of clinical and MRI characteristics of gangliogliomas and DNTs.
- Analysis of tumor location and typical imaging features.
- Correlation of tumor type with epilepsy treatment outcomes.
Main Results:
- Gangliogliomas and DNTs exhibit characteristic imaging features and specific locations.
- These features allow for differentiation from other glial tumors.
- Over 70% of patients with drug-resistant temporal lobe epilepsy due to gangliogliomas and DNTs achieve seizure freedom after lesionectomy.
Conclusions:
- Gangliogliomas and DNTs are distinct entities in drug-resistant epilepsy.
- Accurate MRI-based differentiation from glial tumors is crucial.
- Extended lesionectomy offers a high success rate for seizure control in these specific tumor types.
