Ganglioglioma: Single-institutional experience of 24 cases with review of literature.
BACKGROUND
Ganglioglioma is a common seizure associated tumor. The goal of this study was to observe the postoperative outcome in patients with gangliogliomas.


METHODS
A total 24 patients with gangliogliomas who underwent surgery at our institute from 2008 to 2011 were included. There were 13 males (54%) in our study. A retrospective analysis for the demographic profile, surgery and outcome was performed using STATA software. Literature on this subject was also reviewed, MEDLINE and PUBMED databases were searched.


METHODS
Sixteen patients presented with signs and symptoms of raised intracranial pressure and 12 patients had seizure disorder. Average age at surgery was 20 years (range 7-50 years). Twelve each were located in the temporal lobe and extra-temporal location. Intra-operative electrocorticography (ECoG) alone in three and image guidance alone were used in two patients, respectively. Both ECoG and image guidance were used in one patient and none of them was used in 18 patients. Gross total resection was achieved in 17 patients. After a mean follow-up of 1.6 years (range 3 months to 2.5 years), out of 12 patients with preoperative seizures, 10 (83.3%) were seizure free (Engel class-I) and 2 (16.6%) belonged to Engel class-II. None of the factors, including age at surgery, seizure duration prior to surgery, type of seizures, use of intra-operative ECoG and image guidance, extent of tumor resection, and surgical strategy proved to have significant correlation with postoperative seizure outcome.


CONCLUSIONS
Surgical treatment is effective and safe for patients with gangliogliomas. Neither intra-operative ECoG nor image guidance necessarily leads to better seizure control, although they are useful adjunct for achieving safe and complete tumor resection.
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Vivek
V
Tandon
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Sumit
S
Bansal
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
P Sarat
PS
Chandra
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Ashish
A
Suri
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Manjari
M
Tripathi
Department of Neuropathology, All India Institute of Medical Sciences, New Delhi, India.
Mehar C
MC
Sharma
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Avijit
A
Sarkari
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Ashok K
AK
Mahapatra
Epilepsy surgery; ganglioglioma; intra-operative electrocorticography; neuronavigation
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