Glioneuronal tumors and medically intractable epilepsy: a clinical study with long-term follow-up of seizure outcome after surgery

The present study intends to identify factors that predict postoperative cl inical outcome in patients with gangliogliomas (GG) and dysembryoplastic ne uroepithelial tumors (DNT). We evaluated the medical records of 45 patients with GG and 13 patients with DNT. treated surgically between 1985 and 1995 . We assessed several clinical and histopathological features and analyzed the data statistically. At 5 years postoperatively, 63% of patients with GG and 58%, of patients: with DNT were seizure-free (Engel's class I). Younge r;Ige at surgery (P < 0.01 for GG and P < 0.05 for DNT), total resection (P < 0.01 for GG), shorter duration of epilepsy (P < 0.01), absence of genera lized seizures (P < 0.01 for GG; P < 0.05 for DNT) and absence of epileptif orm discharge in the post-operative EEG (P < 0.01 for GG; P = 0.01 for DNT) predicted a better postoperative seizure outcome. Tumor recurrence with ma lignant progression occurred in eight histologically benign GG and two anap lastic GG and was associated which older age at surgery (P = 0.01) and subt otal resection of the tumor (P < 0.01). Our results indicate that a prompt diagnosis. relatively soon after seizure onset. followed by complete resect ion of glioneuronal tumors provides the best chance for curing epilepsy and preventing their malignant transformation. (C) 2001 Elsevier Science B.V. All rights reserved.