title: [Clinical and histological characteristics of ictal onset zone in cases of intractable epilepsy associated with dysembryoplastic neuroepithelial tumor].
abstract: Although the epileptogenic location of dysembryoplastic neuroepithelial tumors (DNTs) is controversial, it has recently been thought to be located within cortical dysplasia (CD) due to its frequent association with CD. Among the 84 resection surgeries for intractable epilepsy performed in our institution between January 2003 and April 2010, three patients had epileptogenic DNTs. In two cases, chronic subdural electrocorticography (ECoG) was performed, and the ictal onset zone was revealed to be in the cortex around the DNT. The ictal onset zone was resected along with the DNT, and good seizure outcome was achieved. Although histological examination of the ictal onset zone revealed mild gliosis, coexistence of CD was not noted. In the third case, the DNT was located in the left lateral temporal lobe and the intraoperative ECoG revealed frequent paroxysmal activity in the medial temporal lobe. Resection of the lateral temporal lobe involving the tumor did not result in good seizure control. The optimal surgical treatment of DNT is controversial. Some authors consider lesionectomy to be sufficient for good seizure control, whereas others advocate that additional resection of the epileptogenic zone beside the tumor improves outcome. Because the epileptogenic location of DNT varies among cases, it is important to identify its location by preoperative multimodal examinations, including chronic subdural ECoG recordings.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Murakami
authors.forename: Takato
authors.initials: T
authors.lastname: Morioka
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Hashiguchi
authors.forename: Satoshi O
authors.initials: SO
authors.lastname: Suzuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shigeto
authors.forename: Ayumi
authors.initials: A
authors.lastname: Sakata
authors.forename: Tomio
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000473:pathology* / Q000503:physiopathology; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018302:Neoplasms, Neuroepithelial / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D009474:Neurons / Q000473:pathology*