Chronic intractable epilepsy as the only symptom of primary brain tumor.
We identified 39 patients with chronic epilepsy (seizures > or = 2 years) proven to have primary brain tumors. These cases represent approximately 12% of the surgery cases for epilepsy in the same period. Mean age of seizure onset was 13.2 years: mean duration before operation was 10.5 years. Thirty-eight of 39 had normal neurologic examination. Twenty-six tumors were temporal, 7 were frontal, 4 were parietal, and 2 were occipital. Nine of 26 (34.6%) of the temporal group had contralateral interictal EEG spikes. Pathology was 15 ganglioglioma, 13 low-grade astroctoma, 4 oligodendroglioma, 2 low-grade mixed glioma, 1 pleomorphic xanthoastrocytoma, 2 dysembryoplastic neuroepithelial tumor, and 1 ependymoma. Postoperative seizure frequency (minimum follow-up 6 months) ranged from 15 to 16 seizure-free auras only in patients with temporal tumors and total gross tumor removal (mean follow-up 28 months) to 0 of 6 seizure-free in patients with extratemporal tumors who underwent subtotal resection or biopsy.
Morris
H H
HH
Department of Neurology, Cleveland Clinic Foundation, Ohio 44195-5221.
Estes
M L
ML
Gilmore
R
R
Van Ness
P C
PC
Barnett
G H
GH
Turnbull
J
J
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001254:Astrocytoma / Q000150:complications / Q000601:surgery; D001921:Brain / Q000601:surgery; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002908:Chronic Disease; D004569:Electroencephalography; D004827:Epilepsy / Q000209:etiology* / Q000601:surgery; D005260:Female; D018303:Ganglioglioma / Q000150:complications / Q000601:surgery; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D009837:Oligodendroglioma / Q000150:complications / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome