Persistence of the typical spike-wave EEG pattern after surgical excision of a temporal lobe astrocytoma and apical lobectomy.
This is a report on a patient with intractable 'primary' generalized seizures and typical spike-wave EEG patterns, in whom an unexpected temporal lobe astrocytoma was detected by MRI studies. Clinical and electrophysiological studies were performed before and after surgical excision of the tumor and apical temporal lobectomy in an attempt to determine whether 'primary' generalized seizures and EEG patterns and the temporal lobe tumor were only coincident neurological disorders or were indeed related. Before resection, the patient consistently showed a typical spike-wave EEG pattern with no background and paroxysmal activities suggestive of 'secondary' bilateral synchrony in 10 consecutive conventional EEG recordings; neither spontaneous interictal nor ictal ECoG activities suggested focal temporal lobe epileptogenesis. After resection, the patient showed increased pentylenetetrazol (PTZ) convulsive threshold, and reduction in the number of 'primary' generalized seizures, although typical spike-wave EEG discharges persisted. These observations suggest that 'primary' generalized seizures, EEG patterns and the temporal tumor were physiopathologically interrelated, and that both reticulocortical and corticoreticular mechanisms may participate together in the genesis of 'primary' generalized clinical and EEG activities.
Velasco
M
M
Unit of Neurology and Neurosurgery, General Hospital, SS and Division of Neurophysiology, National Medical Center, IMSS Mexico City, Mexico.
Velasco
F
F
Boleaga
B
B
Ondarza
R
R
Velasco
A L
AL
D000328:Adult; D001254:Astrocytoma / Q000503:physiopathology* / Q000601:surgery; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000601:surgery; D004569:Electroencephalography; D004829:Epilepsy, Generalized / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013702:Temporal Lobe / Q000503:physiopathology*