title: Epilepsy surgery of dysembryoplastic neuroepithelial tumors using advanced multitechnologies with combined neuroimaging and electrophysiological examinations.
abstract: OBJECTIVE
  We report three cases of dysembryoplastic neuroepithelial tumor (DNT) with intractable epilepsy which were successfully treated with surgery.
  
  
  METHODS
  In all cases, technology beyond the routine workup was critical to success. Preoperative magnetic resonance imaging, (18)F-fluorodeoxyglucose positron emission tomography (PET), (11)C-methionine-PET, interictal electroencephalography, and intraoperative electrocorticography were utilized in all patients. In individual cases, however, additional procedures such as preoperative magnetoencephalography (Case 1), diffusion tensor fiber tractography, a neuronavigation system, and intraoperative somatosensory-evoked potential (Case 2), and fiber tractography and the neuronavigation-guided fence-post tube technique (Case 3) were instrumental.
  
  
  RESULTS
  In all the cases, the objectives of total tumor resection, resection of the epileptogenic zone, and complete postoperative seizure control and the avoidance of surgical complications were achieved.
  
  
  CONCLUSIONS
  Dysembryoplastic neuroepithelial tumor is commonly associated with medically intractable epilepsy, and surgery is frequently utilized. As DNT may arise in any supratentorial and intracortical locations within or near the critical area of the brain, meticulous surgical strategies are necessary to avoid neurological deficits. We demonstrate in the following three cases how adjunct procedures using advanced multitechnologies with neuroimaging and electrophysiological examinations may be utilized to ensure success in DNT surgery.
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan.
authors: Jun
authors: J
authors: Shinoda
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan.
authors: Kazutoshi
authors: K
authors: Yokoyama
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan.
authors: Kazuhiro
authors: K
authors: Miwa
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan.
authors: Takeshi
authors: T
authors: Ito
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan.
authors: Yoshitaka
authors: Y
authors: Asano
authors: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan.
authors: Shingo
authors: S
authors: Yonezawa
authors: Department of Neurosurgery, Gifu University Graduate School of Medicine, Japan.
authors: Hirohito
authors: H
authors: Yano
keywords: Dysembryoplastic neuroepithelial tumor; Electrocorticography; Epilepsy; Magnetoencephalography; Positron emission tomography; Tractography