DYSEMBRYOPLASTIC NEUROEPITHELIAL TUMORS (DNT): IS THERE ANY FACTOR FOR PREDICTING THE MOST SUITABLE SURGICAL STRATEGY? A STUDY OF 40 CASES
Abstract number :
3.248
Submission category :
Year :
2002
Submission ID :
1591
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Ignacio M. Sfaello, Maria P. Valenti, Edouard Hirsch, Philippe Kahane, Alexis Arzimanoglou. Epilepsy Program, Child Neurology and Metabolic Diseases Dpt., University Hospital Robert Debré, Paris, France; Unite d[ssquote]Explorations Fonctionnelles des Epi
RATIONALE: To identify, retrospectively, factors that could guide the surgical strategy in patients suffering from epilepsy related to a DNT.
METHODS: We evaluated the medical records of 40 patients surgically treated between 1990 and 2000 with histological diagnosis of DNT.
RESULTS: 32 DNT were located in the temporal lobe (TL) and 8 in extra-temporal (ET) regions. Surgery was performed without any recordings in 27% of the cases (10 TL, 1 ET), following video-EEG only in 38% (14 TL, 1 ET), and after depth EEG recordings in 35% (8 TL, 6 ET). Lesionnectomy alone was proposed in only 10 cases (5 TL, 5 ET), and was complete in all. A more extended cortical resection was judged necessary in the remaining 30 patients, among whom the lesion was fully removed in 24. Overall, 70% of our patients were seizure free (Engel class IA) following surgery (follow-up [gt] 2 years), a complete removal of the lesion leading to better results (73% IA) than incomplete resection (33% IA). There was no difference between TL (69% IA) and ET patients (75% IA). The global results were similarly satisfactory and seemed independent from the performance (64% IA) or not (73% IA) of invasive recordings.
CONCLUSIONS: Predicting factors for the surgical strategy of epileptogenic DNTs are yet to be fully defined. Our study indicates that surgical results can be good in both temporal and extra-temporal DNTs following seizure recording with video-EEG and provided that the lesion can be fully removed. A standardized larger resection seems preferable for TL lesions. Such a strategy is not feasible for extra-temporal areas, rendering invasive recordings mandatory.