Clinical features and surgical outcome of epilepsy secondary to ganglioglioma

Ma Kangping; Yi Linhua; Qin Guangbiao; Tan Bojing; Li Yunlin

doi:10.11850/j.issn.1009-122X.2017.08.004

Abstract：Objective To explore the clinical features and surgical outcome of ganglioglioma leading to epilepsy. Methods The clinical data of 17 patients undergoing surgical treatment with epilepsy induced by ganglioglioma were analyzed retrospectively. The age of onset, course of disease, onset symptoms, electroencephalogram (EEG), electrocorticogram (ECoG), head MRI and surgical methods were recorded. Postoperative seizure control was evaluated according to Engel classification. Results The total resection of the tumor was achieved in 17 patients, and extended resection was performed under the guidance of intraoperative EEG monitoring (tailor resection in 7 and lobectomy in 10). The pathological examination revealed ganglioglioma (WHO grade Ⅰ). Complications were seen in 7 patients, including visual field defect in 5, contralateral limb sensory loss in 1 and memory loss in 1. All the 17 patients were followed up for 1.5 to 6 years. During the follow-up, the seizure control was at Engel class Ⅰ. Engel ⅠA was seen in 14 cases and ⅠC in 3 (2 patients had unprovoked seizures in the 2nd and the 4th month respectively after operation, 1 patient had seizures due to a fever 2 years after operation). Statistical analysis found that, in many clinical features of epilepsy, only"secondarily generalized seizure or not"showed statistical difference in effectiveness of seizure control (P=0.022). Conclusions Epilepsy due to ganglioglioma is mostly drug refractory, surgical resection is the main treatment and can get a excellent control outcome. Preoperative comprehensive evaluation of all the clinical epileptic symptoms is beneficial to further improve the efficacy of surgery.