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Titolo:
INTRAOPERATIVE ELECTROCORTICOGRAPHY DURING TUMOR RESECTION - IMPACT ON SEIZURE OUTCOME IN PATIENTS WITH GANGLIOGLIOMAS
Autore:
PILCHER WH; SILBERGELD DL; BERGER MS; OJEMANN GA;
Indirizzi:
UNIV ROCHESTER,SCH MED,DIV NEUROL SURG,BOX 670,601 ELMWOOD AVE ROCHESTER NY 14642 UNIV ROCHESTER,MED CTR,DIV NEUROL SURG ROCHESTER NY 14642 UNIV WASHINGTON,MED CTR,DIV NEUROL SURG SEATTLE WA 98195
Titolo Testata:
Journal of neurosurgery
fascicolo: 6, volume: 78, anno: 1993,
pagine: 891 - 902
SICI:
0022-3085(1993)78:6<891:IEDTR->2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
TEMPORAL-LOBE EPILEPSY; SUBDURAL STRIP ELECTRODES; INTRACTABLE EPILEPSY; BRAIN-TUMORS; HIPPOCAMPAL-FORMATION; SURGICAL-TREATMENT; CHILDREN; MEMORY; LOCALIZATION; CHILDHOOD;
Keywords:
GANGLIOGLIOMA; ELECTROCORTICOGRAPHY; SEIZURE; LESIONECTOMY; EPILEPSY; TUMOR-ASSOCIATED EPILEPSY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
89
Recensione:
Indirizzi per estratti:
Citazione:
W.H. Pilcher et al., "INTRAOPERATIVE ELECTROCORTICOGRAPHY DURING TUMOR RESECTION - IMPACT ON SEIZURE OUTCOME IN PATIENTS WITH GANGLIOGLIOMAS", Journal of neurosurgery, 78(6), 1993, pp. 891-902

Abstract

Gangliogliomas are indolent neoplasms that are often associated with long-standing intractable seizures. The seizure-free outcome followingganglioglioma resection alone (or ''lesionectomy'') has been generally favorable. ranging in most series from 50% to 65%. Thus, the value of resection of epileptogenic cortex in addition to tumor with regard to seizure outcome has been the subject of controversy. The authors describe a series of 12 patients with frontal or temporal lobe gangliogliomas associated with long-standing intractable seizures. In these patients, intraoperative electrocorticography was used to guide the resection of epileptogenic cortex along with tumor. Functional brain mapping, interictal and ictal monitoring of seizures, as well as thorough neuropsychological assessments were performed prior to resection in all cases. Outcome with regard to seizures' tumor recurrence, and neurological deficits was assessed with a mean follow-up period of 3.1 years. There was universal freedom from seizures postoperatively in 11 patients in whom complete or near-complete resection of epileptogenic cortex was achieved. In one patient in whom complete tumor resection and subtotal removal of epileptogenic cortex was achieved, a 95% reduction in seizure frequency was identified. No tumor recurrence or neurological deficits were observed. In a subset of four patients, neuropsychological and cognitive function were evaluated pre- and postoperatively. In these four, a clear trend toward improvement was noted in most functions. Thus, resection of epileptogenic cortex along with tumor may improve seizure outcome in selected patients with tumor-associated epilepsywithout engendering identifiable neurological or cognitive deficits attributable to the incremental resection.

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Documento generato il 30/11/20 alle ore 20:05:32