Multiple band frequency analysis in a child of medial temporal lobe ganglioglioma
Tomoko Mizuno1, Eiji Nakagawa, Hiroshi Sakuma
1Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), 4-1-1, Kodaira, Tokyo 187 8551, Japan.
Insights
Ganglioglioma in young children can cause epileptic spasms. Tumor resection eliminated spasms, suggesting the cerebral cortex may be a source and fast activity analysis could be useful.
Area of Science:
- Pediatric Neurology
- Neuro-oncology
- Epileptology
Background:
- Gangliogliomas are rare tumors often associated with epilepsy.
- Epileptic spasms can manifest in various forms, posing diagnostic challenges.
Observation:
- A 1.5-year-old girl presented with clustered epileptic spasms, sometimes preceded by a dazed and fearful gaze.
- Interictal electroencephalography (EEG) revealed diffuse irregular spikes and slow waves, not hypsarrhythmia.
- Imaging studies (EEG, SPECT, FDG-PET) localized the seizure focus to the right medial temporal lobe.
Findings:
- Ictal EEG and advanced spectral analysis identified high-power gamma rhythms (65-80 Hz) near the tumor.
- Surgical resection of the ganglioglioma resulted in complete resolution of epileptic spasms.
Implications:
- This case suggests the cerebral cortex, specifically within a tumor, can be a source of epileptic spasms.
- Fast rhythmic activity analysis in scalp EEG may aid in diagnosing and localizing the source of epileptic spasms.
- Early diagnosis and surgical intervention for pediatric ganglioglioma can lead to seizure remission.
Abstract:
We report a 1-year 6-month-old girl with ganglioglioma in the right medial temporal lobe who showed epileptic spasms in clusters. Spasms occasionally followed a dazed and fearful gaze. Interictal electroencephalography (EEG) showed diffuse bursts of slightly irregular high-voltage spikes and slow waves without hypsarrhythmia. The findings on ictal EEG, single-photon emission computed tomography, and F-18 fluorodeoxyglucose positron emission tomography indicated focus on the right medial temporal lobe. Ictal fast rhythmic activity analysis of scalp EEG by multiple band frequency analysis showed gamma rhythms at 65-80 Hz with a high spectral power around the tumor area. Epileptic spasms completely disappeared after tumor resection. These findings suggest that the cerebral cortex may be a source of epileptic spasms and indicate the possibility of usefulness of fast activity analysis in this condition.
More Related Videos
13:12Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping
Published on: August 12, 2019
10:22Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
Published on: December 6, 2016