gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Outcome of adult patients with temporal lobe tumors and medically refractory focal epilepsy: first results from the Innsbruck Epilepsy Surgery Program

Outcome bei Erwachsenen mit temporalen Tumoren und pharmacoresistenter Schläfenlappenepilepsie: erste Ergebnisse aus dem Innsbrucker Epilepsiechirurgischen Programm

Meeting Abstract

  • corresponding author R. Bauer - Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Innsbruck
  • J. Dobesberger - Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Innsbruck
  • G. Walser - Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Innsbruck
  • E. Trinka - Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Innsbruck
  • H. Maier - Institut für Pathologie, Medizinische Universität Innsbruck, Innsbruck
  • M. Ortler - Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Innsbruck

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP015

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Veröffentlicht: 4. Mai 2005

© 2005 Bauer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The study examines the surgical and epileptological outcome in adults with temporal lobe neoplasms undergoing surgery within the Innsbruck Epilepsy Surgery Program (INES).

Methods

Fourteen adult patients (mean age 40, 10 women:4 men) with temporal lobe tumors and temporal lobe epilepsy (TLE) were operated five years after presurgical evaluation to identify the correlation between epileptogenic focus and structural lesion. Surgical strategies were tailored to the problem and included temporal lobe resection, extended lesionectomy and extended lesionectomy with resection of the temporomesial structures (amygdala, hippocampus and gyrus parahippocampalis). All patients were available for follow-up at regular intervals after three, six, twelwe months and yearly thereafter. Epileptological outcome was classified according to Engel 1993.

Results

One patient underwent invasive EEG recording after implantation of subdural and depth electrodes. Ten patients were operated on the left side, four on the right side. In three patients, a temporal lobe resection was carried out, in four an extended lesionectomy and in seven an extended lesionectomy including the resection of temporomesial structures. One patient with an astrocytoma III underwent second and third surgical procedures for recurrent disease. Histological examination showed an astrozytoma in five patients, a ganglioglioma/gangliocytoma in five patients, an oligodendroglioma in two patients and single cases of an ependymoma and a dysembryoplastic neuroepithelial tumor respectively. The duration of postoperative follow-up was 15 to 74 months with a mean of 37 months. Epileptological outcome was class I A in eight and I C in one patient. Two patients had outcome class III A and IV A respectively. In three patients, the follow-up period until abstract submission was considered to be too short. Surgical mortallity and permanent neurological morbidity were zero. The patient with the grade III astrocytoma, operated, irradiated and under chemotherapy, had to undergo revision surgery for wound dehiscence and ultimately subduroperitoneal shunting for recurrent subgaleal hygroma.

Conclusions

Patients with drug resistant epilepsy and temporal tumors should undergo evaluation in speicialized epilepsy surgery programs. The epileptological outcome is favourable with benign (grade I and II ) tumors.