Clinical characteristics and postoperative seizure outcome in patients with mild malformation of cortical development and oligodendroglial hyperplasia

Abstract Background Periventricular nodular heterotopia (PNH) is a malformation of cortical development characterized by nodules of abnormally migrated neurons. The cause of posteriorly placed PNH is not well characterised and we present a case that provides insights into the cause of posterior PNH. Case presentation We report a fetus with extensive posterior PNH in association with biallelic variants in LAMC3. LAMC3 mutations have previously been shown to cause polymicrogyria and pachygyria in the occipital cortex, but not PNH. The occipital location of PNH in our case and the proposed function of LAMC3 in cortical development suggest that the identified LAMC3 variants may be causal of PNH in this fetus. Conclusion We hypothesise that this finding extends the cortical phenotype associated with LAMC3 and provides valuable insight into genetic cause of posterior PNH.

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Seizure outcome in temporal glioblastoma surgery: lobectomy as a supratotal resection regime outclasses conventional gross-total resection

Journal of Neuro-Oncology ◽

10.1007/s11060-021-03705-x ◽

2021 ◽

Author(s):

Valeri Borger ◽

Motaz Hamed ◽

Inja Ilic ◽

Anna-Laura Potthoff ◽

Attila Racz ◽

...

Keyword(s):

Tumor Resection ◽

Temporal Lobectomy ◽

Secondary Outcome ◽

Seizure Outcome ◽

Seizure Freedom ◽

Secondary Outcome Measure ◽

Total Resection ◽

Class 1 ◽

Postoperative Seizure ◽

The Impact

Abstract Introduction The postoperative seizure freedom represents an important secondary outcome measure in glioblastoma surgery. Recently, supra-total glioblastoma resection in terms of anterior temporal lobectomy (ATL) has gained growing attention with regard to superior long-term disease control for temporal-located glioblastoma compared to conventional gross-total resections (GTR). However, the impact of ATL on seizure outcome in these patients is unknown. We therefore analyzed ATL and GTR as differing extents of resection in regard of postoperative seizure control in patients with temporal glioblastoma and preoperative symptomatic seizures. Methods Between 2012 and 2018, 33 patients with preoperative seizures underwent GTR or ATL for temporal glioblastoma at the authors’ institution. Seizure outcome was assessed postoperatively and 6 months after tumor resection according to the International League Against Epilepsy (ILAE) classification and stratified into favorable (ILAE class 1) versus unfavorable (ILAE class 2–6). Results Overall, 23 out of 33 patients (70%) with preoperative seizures achieved favorable seizure outcome following resection of temporal located glioblastoma. For the ATL group, postoperative seizure freedom was present in 13 out of 13 patients (100%). In comparison, respective rates for the GTR group were 10 out of 20 patients (50%) (p = 0.002; OR 27; 95% CI 1.4–515.9). Conclusions ATL in terms of a supra-total resection strategy was associated with superior favorable seizure outcome following temporal glioblastoma resection compared to GTR. Regarding above mentioned survival benefit following ATL compared to GTR, ATL as an aggressive supra-total resection regime might constitute the surgical modality of choice for temporal-located glioblastoma.

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Do psychiatric comorbidities predict postoperative seizure outcome in temporal lobe epilepsy surgery?

Epilepsy & Behavior ◽

10.1016/j.yebeh.2009.01.002 ◽

2009 ◽

Vol 14 (3) ◽

pp. 529-534 ◽

Cited By ~ 57

Author(s):

Ricardo Guarnieri ◽

Roger Walz ◽

Jaime E.C. Hallak ◽

Érica Coimbra ◽

Edna de Almeida ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Seizure Outcome ◽

Psychiatric Comorbidities ◽

Postoperative Seizure

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Association Between Anatomical Location of Surgically Induced Lesions and Postoperative Seizure Outcome in Temporal Lobe Epilepsy

Neurology ◽

10.1212/wnl.0000000000013033 ◽

2021 ◽

pp. 10.1212/WNL.0000000000013033

Author(s):

Ezequiel Gleichgerrcht ◽

Daniel L. Drane ◽

Simon Sean Keller ◽

Kathryn A. Davis ◽

Robert Gross ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Anterior Commissure ◽

Piriform Cortex ◽

Seizure Outcome ◽

Seizure Freedom ◽

Anatomical Location ◽

Surgical Interventions ◽

Postoperative Seizure ◽

Promising Source

Objective:To determine the association between surgical lesions of distinct grey and white structures and connections with favorable post-operative seizure outcomes.Methods:Patients with drug-resistant temporal lobe epilepsy (TLE) from three epilepsy centers were included. We employed a voxel-based and connectome-based mapping approach to determine the association between favorable outcomes and surgery-induced temporal lesions. Analyses were conducted controlling for multiple confounders, including total surgical resection/ablation volume, hippocampal volumes, side of surgery, and site where the patient was treated.Results:The cohort included 113 patients with TLE [54 women; 86 right-handed; 16.5 (SD = 11.9) age at seizure onset, 54.9% left] who were 61.1% free of disabling seizures (Engel class 1) at follow-up. Postoperative seizure freedom in TLE was associated with 1) surgical lesions that targeted the hippocampus as well as the amygdala-piriform cortex complex and entorhinal cortices; 2) disconnection of temporal, frontal, and limbic regions through loss of white matter tracts within the uncinate fasciculus, anterior commissure, and fornix; and 3) functional disconnection of the frontal (superior and middle frontal gyri, orbitofrontal region) and temporal (superior and middle pole) lobes.Conclusions:Better postoperative seizure freedom are associated with surgical lesions of specific structures and connections throughout the temporal lobes. These findings shed light on the key components of epileptogenic networks in TLE and constitute a promising source of new evidence for future improvements in surgical interventions.Classification of Evidence:This study provides Class II evidence that for patients with temporal lobe epilepsy, postoperative seizure freedom is associated with surgical lesions of specific temporal lobe structures and connections.

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Pediatric Epilepsy Surgery at the Epilepsy Center Linz: Postoperative Seizure Outcome, Prognostic Factors, and Safety

10.1055/s-0041-1739678 ◽

2021 ◽

Author(s):

G. Gröppel ◽

A. Hengsberger ◽

G. Schwarz ◽

C. Auer ◽

B. Stark ◽

...

Keyword(s):

Prognostic Factors ◽

Epilepsy Surgery ◽

Pediatric Epilepsy ◽

Seizure Outcome ◽

Pediatric Epilepsy Surgery ◽

Epilepsy Center ◽

Postoperative Seizure

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A case of mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy (MOGHE)

Diagnostic radiology and radiotherapy ◽

10.22328/2079-5343-2021-12-3-93-100 ◽

2021 ◽

Vol 12 (3) ◽

pp. 93-100

Author(s):

V. S. Khalilov ◽

A. N. Kislyakov ◽

T. V. Basalay ◽

A. V. Levov ◽

A. A. Kholin

Keyword(s):

White Matter ◽

Frontal Lobe ◽

Focal Cortical Dysplasia ◽

Epileptiform Activity ◽

Cortical Development ◽

Dynamic Mri ◽

Subtotal Resection ◽

Pharmacoresistant Epilepsy ◽

Malformation Of Cortical Development ◽

The Right

Recently, in the scientist community of specialists dealing with structural epilepsy, it has been noticed an increasing interest in a special form of cortical development disorder not to be included in the ILAE Classification of the epilepsies the 2017 revision. It is so-called mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy (MOGHE). There are a number of publications devoted to the neuroimaging features of MOGHE, which are possible to distinguish from other epileptogenic substrates in comparisons with clinical/anamnestic data and dynamic observation. Our paper describes the case of a patient under 6 years suffering from pharmacoresistant epilepsy with histologically confirmed MOGHE, and having undergone the procedure of epileptic surgery. MRI showed an increased intensity of the T2/FLAIR signal from the white matter in combination with signs of laminar hyperintensivity, regional sulcation disturbance, smoothness of gray-white matter demarcation in the right frontal lobe. A signal intensification from the white matter with the formation similarity of the «transmantl» sign and further pronounced smoothness of the gray-white matter demarcation was observed on dynamic MRI. These changes were estimated as focal cortical dysplasia. Pre-surgical examination revealed a correlation of epileptiform activity with MRI changes. The subtotal resection of the right frontal lobe and the morphological conclusion established the presence of MOGHE was performed.

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