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[A case of infantile ganglioglioma]
1Department of Neurosurgery, Yamaguchi University School of Medicine.
Insights
This study presents a rare case of infantile ganglioglioma, a slow-growing congenital brain tumor causing complex partial seizures. Surgical removal led to complete seizure freedom, highlighting early diagnosis and intervention importance.
Area of Science:
- Pediatric Neurology
- Neuro-oncology
- Developmental Neuroscience
Background:
- Gangliogliomas are typically diagnosed in childhood but are exceptionally rare in infancy.
- Intractable seizures in infants necessitate thorough investigation for underlying brain pathologies.
Observation:
- A two-year-old girl presented with a history of complex partial seizures starting in infancy.
- Imaging revealed a slowly enlarging, high-density mass in the left medial temporal lobe.
- Histological examination confirmed the diagnosis of ganglioglioma, with synaptophysin aiding diagnosis.
Findings:
- Surgical resection of the ganglioglioma resulted in complete seizure remission.
- The tumor exhibited slow enlargement, suggesting a congenital origin.
- Synaptophysin immunohistochemistry proved valuable for accurate histological classification.
Implications:
- This case underscores the possibility of gangliogliomas presenting as congenital brain tumors in infancy.
- Early detection and surgical management of infantile gangliogliomas can lead to favorable outcomes.
- Further research into the developmental origins and early-onset presentation of gangliogliomas is warranted.
Abstract:
Gangliogliomas are common in childhood, but rare in infancy. The authors report a rare case of ganglioglioma who had an initial episode of complex partial seizure in infancy. A two-year-old girl was admitted for the surgical treatment of intractable seizures. She presented with an annual episode of seizure at two months old. The CT scan at 2 months old showed a light high-density tumor in the left medial temporal lobe. However, she had no treatment because she had no seizure since then and her psychomotor development was normal. She was treated with anticonvulsants from 1 year and 10 months old since seizures recurred. She was admitted to our ward at 2 years old because the frequency of seizures increased. Plain CT on admission showed an enlarged high density mass in left medial temporal lobe. The T1 weighted images of MRI demonstrated the mass to be isointense compared with the cortex, with homogeneously contrast enhancement. Total removal of the tumor was performed and histological diagnosis was ganglioglioma. She is seizure-free after surgery and synaptophysin was useful for the histological diagnosis. This case may indicate that gangliogliomas can be a congenital brain tumor which slowly enlarges.