Clinical features and surgical outcome of patients with indolent brain tumors and epilepsy

• Autor(a) principal: Melo, Julieta G. S. P. [UNIFESP]
• Data de Publicação: 2007
• Outros Autores: Centeno, Ricardo Silva [UNIFESP], Malheiros, Suzana Maria Fleury [UNIFESP], Ferraz, Fernando Antonio Patriani [UNIFESP], Stávale, João Norberto [UNIFESP], Carrete Junior, Henrique [UNIFESP], Sakamoto, Américo Ceiki [UNIFESP], Yacubian, Elza Márcia Targas [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000smmv
• DOI: 10.1590/S1676-26492007000200005
• Texto Completo: http://dx.doi.org/10.1590/S1676-26492007000200005; http://repositorio.unifesp.br/handle/11600/3746
• topic: indolent brain tumors; epilepsy; surgical outcome; tumores cerebrais indolentes; epilepsia; tratamento cirúrgico

INTRODUCTION: In this study the authors review the outcomes of 22 patients with medically refractory epilepsy and slow growth brain tumors. OBJECTIVES: Evaluate the clinical, electrophysiological, operative, and histopathological features. PATIENTS AND RESULTS: The majority of the tumors were located in the temporal lobe (n = 20) and involved the cortical gray matter. The most frequent tumors were gangliogliomas (n = 9), astrocytomas grade I and II (n = 6), dysembryoplastic neuroepithelial tumors (n = 5) and ganglioneuroma (n = 2). The biological behavior of the tumors was strikingly indolent, as indicated by a long preoperative history of chronic seizures (mean, 14 years). Mean follow-up time after resection was 27 months, and according to Engel s classification, 85% were seizure-free, 10% showed a reduction of seizure frequency of at least 90%, and 5% had reduction in seizure frequency at least 75%. CONCLUSION: The data indicate that neoplasms associated with pharmacoresistent epilepsy constitute a distinct clinicopathological group of tumors that arise in young patients, involve the cortex, and exhibit indolent biological behavior for many years. Complete surgical removal of these tumors, including the epileptogenic area, can achieve excellent seizure control.