Pre-Surgery MR-Visualization of The Epileptogenic Supratentorial Brain Tumors in Children
DOI:
https://doi.org/10.61788/njn.v2i15.15Keywords:
Neurovisualization, brain tumors in children, symptomatic focal epilepsy, epilepsy surgeryAbstract
Symptomatic focal epilepsies are commonly caused by the supratentorial brain tumors in chtldren. Among the 79 pediatric patients with supratentorial brain tumors 56 patients had symptomatic epilepsy (69,3%). The most epileptogenic tumors were dysembryoplastic neuroepithelial tumors (DNET), diffuse astrocytomas (DA) and gangliogliomas (GG). In all the cases of DNET and in 4 patients with GG epileptic seizures were the first manifestation, and in 4 of 5 cases of DNEO they were the only clinical sign of tumor. On the neuroimaging the MR-features of DNET, DA and GG were represented by iso- or hypointensive signal on T1 weighted image (WI) and varying in intensity from moderate to hyperintensive signal in T2 and FLAIR WI, while in cases with DNET and GG practically no mass effect and perifocal edema were seen, and on FLAIR WI the so-called "spume-like" (multicystic) structure was most clearly observed. During the follow up period no significant changes in the dimensions of identified DNET and GG were observed. In one case the combination of DNET with focal cortical dysplasia was noted. In DA it is difficult to distinguish the perifocal edema from tumorous tissue and normal brain tissue, and the growth potential of tumor is slow. The contrast enhancement of these tumors is ambiguous. Along with DNET (which is epileptogenic in 100% of cases), the most epileptogenic brain tumors are DA (in 91.7% of cases) and GG (in 80% of cases) which should be excluded in drug-resistant cases of focal epilepsy.
References
Van Breemen M.S., Wilms E.B., Vecht C.J. Epilepsy in patients with brain tumours: epidemiology, mechanisms, and management // Lancet Neurol. - 2007.V.6. P.421-30.
Roberto G., Alessandro C., Francesca F., Maria M.M., Maria G.B., Paolo N., Andrea R., Angela P., Miriam T., Armando C., Maria L.G., Pasquale S. Epilepsy associated with supratentorial brain tumors under 3 years of life // Epilepsy Research. - 2009. V.87. P. 184-189.
Алиханов А.А., Генералов В.О., Демушкина А.А., Перепелова Е.М., Шимановский Н.Л., Чадаев В.А. Визуализация эпилептогенных поражений головного мозга у детей // Издательский дом Видар. - 2009. - с.199-219.
Barcovich A.J, Kuzniecky R.I., Jackson G.D., Guerrini R., Dobyns W.B. A develop-mental and genetic classification for malformations of cortical development // Neurology. - 2005. - V.65. - P.1873-87.
Van Veelen ML, Avezaat CJ, Kros JM, van Putten W, Vecht C. Supratentorial low grade astrocytoma: prognostic factors, dedifferentiation, and the issue of early versus late surgery. J Neurol Neurosurg Psychiatry 1998; 64: 581-87.
В.Н. Корниенко, И.Н. Пронин Атлас Диагностическая нейрорадиология // Издательство ИП «Андреева Т.М. - 2006. - с. 455-599.
Urbach H. MRI of long-term epilepsy-associated tumors // Semin Ultrasound CT MRI. - 2008. - V.29 (1). - P.40-6.
Luyken C., Blumcke I., Fimmers R., Urbach H., Wiestler O.D., Schramm J. Supratentorial gangliogliomas: histopathologic grading and tumor recurrence in 184 patients with a median follow-up of 8 years // Cancer. - 2004. - V.101. - P.146-55.
Villarejo F., Alvarez-Sastre C., Martinez-Quinones J., Colomar P., Martin-Gamero A.P., Perez-Diaz C. Dysembryoplastic neuroepithelial tumors // Revista de Neurologia. - 1999. - V.29 (9). - P.810-4.
Fernandez C. Et al. The usefulness of MRI in the diagnosis of disembryoplastic neuroepithelial tumor in children: a study of 14 cases. AJNR, 2003, 24: 829-834.
Stanescu Cosson R. Et al. Disembryoplastic neuroepithelial tumors: CT, MR findings and imaging fjlloup: a study of 53 cases. J. Neuroradiol., 2001, 28: 230-240.
Barcovich A.J, Congenital malformations of the brain and skull. In: Barcovich A.J, ed. Pediatric neuroimaging 4Th ed. Philadelphia: Lippincott, Williams & Wilkins, 2005. 291-439.
Takahashi A., Hong S.C., Seo D.W., Hong S.B., Lee M., Suh Y.L. Frequent association of cortical dysplasia in dysembryoplastic neuroepithelial tumor treated by epilepsy surgery // Surgical Neurology. - 2005. - V.64(5). - P.419-27.
Provenzale G.M., Mukundan S., Dewhirst M. The role of blood-brain permeability in brain tumors imaging and therapeutics. Am. J. Roentgenol., 2005, 185: 763-767.
Aronica E., Leenstra S., van Veelen C.W., van Rijen P.C., Hulsebos T.J., Tersmette A.C., Yankaya B., Troost, D. Glioneuronal tumors and medically intractable epilepsy: a clinical study with long-term follow-up of seizure outcome after surgery // Epilepsy Res. - 2001. - V.43. - P.179-191.
Ogiwara H., Nordli D.R., DiPatri A.J., Alden T.D., Bowman R.M., Tomita T. Pediatric epileptogenic gangliogliomas: seizure outcome and surgical results // J. Neurosurg. Pediatr. - 2010. - V.5 (3). - P.271-6.
Selch M. Gangliogliomas: experience with 3 patients and review of the literatute. Am. J. Clin. Onc., 1998, 21: 557-564.
Morris H.H., Matkovic Z., Estes M.L., Prayson R.A., Comair Y.G., Turnbull J., Najm I., Kotagal P., Wyllie E. Ganglioglioma and intractable epilepsy: clinical and neurophysiologic features and predictors of outcome after surgery // Epilepsia. - 1998. - V.39 (3). - P.307-13.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 National Association of Neurologists
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
