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Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
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Angiocentric glioma-induced seizures in a 2-year-old child

Stephen P Fulton1, Dave F Clarke, James W Wheless

  • 1Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN 38105, USA.

Journal of Child Neurology
|March 24, 2009
PubMed

Insights

A pediatric patient with drug-resistant epilepsy underwent successful tumor resection of an angiocentric glioma. Surgical removal of the lesion led to complete seizure freedom, highlighting effective treatment for pediatric brain tumors.

Area of Science:

  • Pediatric Neurology
  • Neuro-oncology
  • Epileptology

Background:

  • Medically refractory seizures in children pose significant management challenges.
  • Angiocentric gliomas are rare brain tumors that can cause intractable epilepsy.
  • Accurate localization of seizure onset is crucial for surgical planning.

Observation:

  • A 2-year-old child presented with severe, drug-resistant seizures.
  • Neuroimaging revealed a right frontoparietal parasagittal angiocentric glioma.
  • Intracranial EEG monitoring with depth electrodes localized seizure onset to the tumor itself.

Findings:

  • Ictal activity originated within the angiocentric glioma, not adjacent brain tissue.
  • Seizure propagation involved the surrounding cortex and the hand motor area.
  • Surgical lesionectomy successfully removed the tumor while preserving eloquent cortex.

Implications:

  • This case demonstrates the efficacy of epilepsy surgery in pediatric patients with tumor-associated epilepsy.
  • Accurate localization of seizure origin within the tumor is key to successful surgical outcomes.
  • Complete resection of the angiocentric glioma resulted in sustained seizure freedom and improved quality of life.

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