Epilepsy Surgery for Focal Cortical Dysplasia and Dysembryoplastic Neuroepithelial Tumor.

Accession number;00A0195768
Title;Epilepsy Surgery for Focal Cortical Dysplasia and Dysembryoplastic Neuroepithelial Tumor.
Author; FUKUDA MASAFUMI (National Sanatorium Nishi-Niigata-Chuo Byoin, JPN) KAMEYAMA SHIGEKI (National Sanatorium Nishi-Niigata-Chuo Byoin, JPN) TOMIKAWA MASARU (National Sanatorium Nishi-Niigata-Chuo Byoin, JPN) WACHI MANABU (Kokuritsuryoyoshonishiniigatachuobyointenkanse) SASAGAWA MUTSUO (Kokuritsuryoyoshonishiniigatachuobyointenkanse) KANAZAWA OSAMU (Kokuritsuryoyoshonishiniigatachuobyointenkanse) KAWAGUCHI TADASHI (Niigata Univ.) YAMASHITA SHIN'YA (Niigata Univ.) TANAKA RYUICHI (Niigata Univ.)
Journal Title;Neurol Surg
Journal Code:Z0684A
ISSN:0301-2603
VOL.28;NO.2;PAGE.135-144(2000)
Figure&Table&Reference;FIG.7, TBL.2, REF.20
Pub. Country;Japan
Language;Japanese
Abstract;We studied six patients with focal cortical dysplasia (CD) and four patients with dysembryoplastic neuroepithelial tumor (DNT) who had surgical resection for medically intractable epilepsy. In all CD patients, ictal single photon emission computed tomography (SPECT) using 99mTc-ECD revealed hyperperfusion in the regions where magnetic resonance (MR) imaging showed CD abnormalities. Interictal epileptiform activity and ictal seizure onset on electrocorticography using subdural strip or grid electrodes were demonstrated in the CD itself. In contrast, in all DNT patients, interictal SPECT disclosed hypoperfusion in the area of the lesions. Ictal SPECT in one DNT patient disclosed hyperperfusion in the superior area of the region where MR imaging showed cystic abnormalities. Interictal spiking in all DNT patients and ictal seizure onset in two DNT patients were demonstrated not in the lesions themselves but in the distinct zone from the region of the tumor-involved brain. All CD patients who underwent lesionectomy became seizure-free with a mean follow-up period of 33.5 months. All DNT patients who underwent lesionectomy and resection of the epileptogenic cortex became seizure-free or had their seizure significantly reduced a mean follow-up period of 41.5 months. We conclude that CDs have intrinsic epileptogenicity, while DNTs have epileptogenicity not intrinsically but in encompassed cortical surface areas. (author abst.)
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