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ISSN 2225-4676 (Electronic)

2017, Number 1

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Rev Cubana Neurol Neurocir 2017; 7 (1)

Brain tumors in the epilepsy surgery program of International Center for Neurological Restoration (La Habana)

Estupiñán DBO, García MI, Morales CLM, Báez MMM, Lorigados PL, Quintanal CN, Prince LJA, García NME, Fernández JI, Grave PKA

Language: Spanish
References: 32
Page: 25-33
PDF size: 532.95 Kb.


ABSTRACT

OBJECTIVE: To determine the association of brain tumors with other lesions in patients undergoing epilepsy surgery at the International Center for Neurological Restoration (CIREN – Havana, Cuba), as well as the impact on clinical evolution following the resection guided by electrocorticography (ECoG).
METHODS: Of the 47 patients with epilepsy operated in the CIREN, a descriptive study was conducted of those with confirmed diagnosis of brain tumor. Resections guided by ECoG were carried out and the histopathological diagnosis was carried out according to the classification of the World Health Organization. The system proposed by the International League against Epilepsy was used for the microscopic diagnosis of focal cortical dysplasia. The modified Engel scale was applied for post-surgical follow-up.
RESULTS: The average age prior to surgery was 32.8 years (5-19 years) and the mean duration of epilepsy was 21.5 years (2-42 years). Histological analysis confirmed the presence of tumor in 6 patients (3 Gangliogliomas, 2 pilocytic astrocytomas and 1 dysembryoplastic neuroepithelial tumor); 4 corresponded to the temporal lobe and 2 extratemporals and of them, 3 were associated with focal cortical dysplasia. The postsurgical evolution was satisfactory, being free of seizures in its last evaluation, 5 patients (range of 7 and 9 years, grades Ia, Ib and Ic). The remaining patient achieved a considerable reduction in seizures (5 and half years of surgery with a grade IIIa).
CONCLUSIONS: The resection of the tumor guided by ECoG allows diagnosing other unidentified lesions in the magnetic resonances in 50 % of the cases and whose epileptogenicity has been demonstrated. Favorable clinical evolution in most patients suggests the usefulness of intraoperative ECoG for the adequate resection of the epileptogenic zone.


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