Angiocentric Glioma and Surrounding Cortical Dysplasia Manifesting as Intractable Frontal Lobe Epilepsy

Abstract BACKGROUND: Although the outcome of epilepsy surgery changes with time, few studies have considered longitudinal changes after frontal lobe epilepsy (FLE) surgery. OBJECTIVE: To assess the longitudinal changes after FLE surgery. METHODS: Resection of the seizure onset zone was performed in 76 patients with FLE. Invasive monitoring was performed in 56 of these 76. Awake craniotomy was performed in 43 of the 76 patients. More than 50% of patients were followed up for at least 7 years. The mean follow-up was 81 months. RESULTS: For all patients, the seizure-free rate was 79% at 6 months, 64% at 1 year, 55% at 2 years, and 55% at 7 years. For patients with cortical dysplasia, the seizure-free rate was 72% at 6 months, 53% at 1 year, 51% at 2 years, and 46% at 7 years. For patients with tumor, the seizure-free rate was 89% at 6 months, 83% at 1 year, 83% at 2 years, and 74% at 7 years. Patients with tumor showed better outcome than those with cortical dysplasia (P = .04). Although the overall seizure-free rate became stable after 2 years, individual status changed for up to 5 years. Seizures recurred in 11 patients within 1 year (early recurrence) and in 12 patients by 1 to 5 years (late recurrence). Antiepileptic drug (AED) medication was adjusted in all patients with recurrence. Patients with late recurrence had a more favorable response (Engel class I or II) than early recurrence (P < .01). CONCLUSION: The overall seizure outcome changes mostly during the first year. However, individual seizure status changes for up to 5 years. The outcome of late recurrence is favorable to AED adjustment.

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Thin isotropic FLAIR MR images at 1.5T increase the yield of focal cortical dysplasia transmantle sign detection in frontal lobe epilepsy

Epilepsy Research ◽

10.1016/j.eplepsyres.2017.02.018 ◽

2017 ◽

Vol 132 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Vasileios Kokkinos ◽

Alexandros Kallifatidis ◽

Eftychia Z. Kapsalaki ◽

Nikolaos Papanikolaou ◽

Kyriakos Garganis

Keyword(s):

Frontal Lobe ◽

Focal Cortical Dysplasia ◽

Cortical Dysplasia ◽

Frontal Lobe Epilepsy ◽

Mr Images ◽

Sign Detection

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P156 Frontal lobe epilepsy caused by focal cortical dysplasia type II in left precentral region – considerations prior to surgery

European Journal of Paediatric Neurology ◽

10.1016/s1090-3798(09)70214-4 ◽

2009 ◽

Vol 13 ◽

pp. S68-S69

Author(s):

N. Barišić ◽

S. Kessler ◽

B. Bunoza ◽

T. Pieper ◽

M. Kudernatsch ◽

...

Keyword(s):

Frontal Lobe ◽

Focal Cortical Dysplasia ◽

Cortical Dysplasia ◽

Frontal Lobe Epilepsy ◽

Type Ii

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Subclinical Abnormal Gyration Pattern, a Potential Anatomic Marker of Epileptogenic Zone in Patients With Magnetic Resonance Imaging–Negative Frontal Lobe Epilepsy

Neurosurgery ◽

10.1227/neu.0b013e318212bb1a ◽

2011 ◽

Vol 69 (1) ◽

pp. 80-94 ◽

Cited By ~ 16

Author(s):

Jean Régis ◽

Manabu Tamura ◽

Michael C Park ◽

Aileen McGonigal ◽

Denis Rivière ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Frontal Lobe ◽

Focal Cortical Dysplasia ◽

Cortical Dysplasia ◽

Frontal Lobe Epilepsy ◽

Potential Contribution ◽

Epileptogenic Zone ◽

Resonance Imaging

Abstract BACKGROUND: Epilepsy surgery for magnetic resonance imaging (MRI)-negative patients has a less favorable outcome. OBJECTIVE: Detection of subclinical abnormal gyration (SAG) patterns and their potential contribution to assessment of the topography of the epileptogenic zone (EZ) is addressed in MRI-negative patients with frontal lobe epilepsy. METHODS: Between September 1998 and July 2005, 12 MRI-negative frontal lobe epilepsy patients underwent stereoelectroencephalography with postcorticectomy follow-up of longer than 1 year (average, 3.3 years). Original software (BrainVISA/Anatomist, http://brainvisa.info) trained on a database of normal volunteers was used to determine which sulci had morphology out of the normal range (SAG). Topography of the EZ, SAG pattern, corticectomy, postoperative seizure control, and histopathology were analyzed. RESULTS: At last follow-up, 8 of 12 patients (66.7%) were Engel class I (7 IA and 1 IB), 2 class II, and 2 class IV. Small focal cortical dysplasia was histologically diagnosed in 9 of the 12 patients (75%), including 7 of 8 seizure-free patients (87.5%). A SAG pattern was found to be in the EZ area in 9 patients (75%), in the ipsilateral frontal lobe out of the EZ in 2, and limited to the contralateral hemisphere in 1. CONCLUSION: SAG patterns appear to be associated with the topography of the EZ in MRI-negative frontal lobe epilepsy and may have a useful role in preoperative assessment. Small focal cortical dysplasia not detected with MRI is often found on histopathological examination, particularly in the depth of the posterior part of the superior frontal sulcus and intermediate frontal sulcus, suggesting a specific developmental critical zone in these locations.

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Lifelong and new nocturnal events found to be right frontal lobe epilepsy secondary to a cortical dysplasia

Sleep Medicine ◽

10.1016/j.sleep.2009.08.005 ◽

2010 ◽

Vol 11 (1) ◽

pp. 102-104 ◽

Cited By ~ 1

Author(s):

Eli S. Neiman ◽

Katherine H. Noe ◽

Michael Seyffert ◽

Joseph F. Drazkowski ◽

Joseph I. Sirven ◽

...

Keyword(s):

Frontal Lobe ◽

Cortical Dysplasia ◽

Frontal Lobe Epilepsy

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Novel pathological abnormalities of deep brain structures including dysplastic neurons in anterior striatum associated with focal cortical dysplasia in epilepsy

Journal of Neurosurgery Pediatrics ◽

10.3171/2012.6.peds11325 ◽

2012 ◽

Vol 10 (3) ◽

pp. 217-225 ◽

Cited By ~ 8

Author(s):

Takanobu Kaido ◽

Taisuke Otsuki ◽

Akiyoshi Kakita ◽

Kenji Sugai ◽

Yoshiaki Saito ◽

...

Keyword(s):

White Matter ◽

Frontal Lobe ◽

Focal Cortical Dysplasia ◽

Brain Structures ◽

Cortical Dysplasia ◽

Frontal Lobe Epilepsy ◽

Periventricular White Matter ◽

Dysmorphic Neurons ◽

Dysplastic Neurons ◽

Deep Brain

Object Some patients are not seizure free even after epileptogenic cortical resection. The authors recently described a case of frontal lobe epilepsy cured after the resection of periventricular white matter and striatum, in which dysplastic neurons were revealed. The authors attempted to confirm similar cases. Methods They reviewed the records of 8 children with frontal lobe epilepsy who had daily (7) or monthly (1) seizures and underwent resections including deep brain structures. Results Five patients underwent multiple resections. Neuroimaging of the deep structures showed the transmantle sign in 3 patients, ictal hyperperfusion in 6, reduced iomazenil uptake in 2, and spike dipole clustering in 6. All patients became seizure free postoperatively. Focal cortical dysplasia of various types was diagnosed in all patients. Dysmorphic neurons were found in the cortex and subcortical white matter of 5 patients. The striatum was verified in 3 patients in whom dysmorphic neurons were scattered. In the periventricular white matter, prominent astrocytosis was evident in all cases. Conclusions Pathological abnormalities such as dysmorphic neurons and astrocytosis in deep brain structures would play a key role in epileptogenesis.

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