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Epilepsy associated tumors: Review article.

Marco Giulioni1, Gianluca Marucci1, Matteo Martinoni1

  • 1Marco Giulioni, Matteo Martinoni, IRCCS Institute of Neurological Sciences of Bologna, Division of Neurosurgery, Bellaria Hospital, 40139 Bologna, Italy.

World Journal of Clinical Cases
|November 19, 2014
PubMed
Summary

Long-term epilepsy associated tumors (LEAT) are a common cause of focal epilepsy, often resistant to medication. Early surgical intervention offers excellent seizure control and improved outcomes for patients with these tumors.

Keywords:
Dysembryoplastic neuroepithelial tumorEpilepsyEpilepsy surgeryGangliogliomaGlioneuronal tumorsLesionectomyLong-term epilepsy associated tumorsLow grade tumors

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Area of Science:

  • Neurology
  • Neurosurgery
  • Oncology

Background:

  • Long-term epilepsy associated tumors (LEAT) are a significant cause of focal epilepsies, particularly glioneuronal tumors in the temporal lobe.
  • These tumors frequently coexist with cortical dysplasia or neuronal migration abnormalities, complicating epilepsy management.
  • Epilepsy linked to LEAT is often refractory to antiepileptic drugs but highly responsive to surgical intervention.

Purpose of the Study:

  • To evaluate the optimal management strategy for tumor-related focal epilepsies.
  • To emphasize the benefits of early surgical treatment for LEAT-associated epilepsy.
  • To address the controversy surrounding the management of these complex cases in epilepsy surgery.

Main Methods:

  • Review of current literature and clinical practices regarding LEAT and epilepsy surgery.
  • Analysis of epileptogenic mechanisms in temporo-mesial LEAT.
  • Assessment of seizure outcomes and treatment responses in epilepsy surgery patients with LEAT.

Main Results:

  • LEAT-associated epilepsy is generally poorly controlled by antiepileptic drugs.
  • Surgical treatment demonstrates high responsiveness and excellent seizure outcomes for LEAT.
  • Temporo-mesial LEAT exhibit complex epileptogenic networks requiring specialized surgical strategies.

Conclusions:

  • Early surgical treatment for LEAT-associated epilepsy should be considered, irrespective of pharmacoresistance.
  • Surgery can mitigate the consequences of uncontrolled seizures, side effects of long-term medication, and the risk of malignant transformation.
  • An epilepsy surgery-oriented strategy offers excellent seizure outcomes for patients with LEAT.