Book contents
- Frontmatter
- Contents
- Acknowledgment
- Preface
- 1 History of epilepsy surgery
- 2 The search for the epileptic focus: investigation of the surgical candidate
- 3 Surgical anatomy
- 4 Neuronavigation and preoperative brain mapping
- 5 Stereoelectroencephalography (stereotactic intracranial recording)
- 6 Anesthesia and awake procedure
- 7 Peroperative brain mapping
- 8 Endopial resection (intervascular endopial gyral emptying)
- 9 Surgery of temporal lobe epilepsy: cortico-amygdalohippocampectomy
- 10 Surgery of temporal lobe epilepsy: transcortical selective amygdalohippocampectomy
- 11 Surgery of central area epilepsy
- 12 Surgery of frontal lobe epilepsy
- 13 Surgery of parietal lobe epilepsy
- 14 Surgery of insular lobe epilepsy
- 15 Surgery of occipital lobe epilepsy
- 16 Hemispherectomy
- 17 Callosotomy
- 18 Epilepsy and brain tumors
- 19 Surgical treatment of cortical dysplasias
- 20 Reoperations in failed epilepsy surgery
- 21 Alternative procedures in surgery for epilepsy
- 22 Complications of epilepsy surgery
- 23 Quality of life after epilepsy surgery
- Index
- References
18 - Epilepsy and brain tumors
Published online by Cambridge University Press: 05 October 2012
- Frontmatter
- Contents
- Acknowledgment
- Preface
- 1 History of epilepsy surgery
- 2 The search for the epileptic focus: investigation of the surgical candidate
- 3 Surgical anatomy
- 4 Neuronavigation and preoperative brain mapping
- 5 Stereoelectroencephalography (stereotactic intracranial recording)
- 6 Anesthesia and awake procedure
- 7 Peroperative brain mapping
- 8 Endopial resection (intervascular endopial gyral emptying)
- 9 Surgery of temporal lobe epilepsy: cortico-amygdalohippocampectomy
- 10 Surgery of temporal lobe epilepsy: transcortical selective amygdalohippocampectomy
- 11 Surgery of central area epilepsy
- 12 Surgery of frontal lobe epilepsy
- 13 Surgery of parietal lobe epilepsy
- 14 Surgery of insular lobe epilepsy
- 15 Surgery of occipital lobe epilepsy
- 16 Hemispherectomy
- 17 Callosotomy
- 18 Epilepsy and brain tumors
- 19 Surgical treatment of cortical dysplasias
- 20 Reoperations in failed epilepsy surgery
- 21 Alternative procedures in surgery for epilepsy
- 22 Complications of epilepsy surgery
- 23 Quality of life after epilepsy surgery
- Index
- References
Summary
Incidence of epilepsy as a symptom of brain tumor
Tumors that cause chronic intractable epilepsy are usually low-grade benign gliomas. Whether epilepsy is a specific property of the tumor or the brain's reaction to the tumor remains to be explored. Benign gliomas can masquerade as static cicatricial lesions and may not come to the surgeon's attention for long periods of time due to the misdiagnosis. Low-grade gliomas account for 60–90% of the tumors in most series.
Epilepsy is frequently the only presenting symptom of a tumor, and in the past, the diagnosis was frequently missed due to poor imaging or a lack of imaging. Advances in cerebral imaging have made early diagnosis more likely to be achieved today. In several surgical series, the incidence of tumors associated with epilepsy ranged between 10% and 15%. In a study from the MNI, Rasmussen reported 184 patients operated on between 1929 and 1971 with chronic epilepsy secondary to slow-growing gliomas. It is interesting to note in this study that prior to the era of computed tomography, 10% of the tumors were not suspected until disclosed at surgery. In another MNI series, 20% of the patients operated on for focal cerebral seizures were found to have a space-occupying lesion (a tumor in the majority of cases) with a small number of non-neoplastic vascular lesions.
- Type
- Chapter
- Information
- Techniques in Epilepsy SurgeryThe MNI Approach, pp. 216 - 233Publisher: Cambridge University PressPrint publication year: 2012
References
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