Introduction: There is controversy between the extension of the surgical resection of electrophysiologically monitored brain tumors and the postoperative clinical evolution of patients with pharmacoresistant temporal lobe epilepsy (TLE).
Objective: To evaluate the histopathological spectrum and the electroclinical and imagenologic characteristics, as well as the clinical evolution in patients with neuroepithelial tumors included in the program of epilepsy surgery at CIREN.
Patients and methods: Cases with tumors and pharmaco resistant epilepsy operated from 2002 – 2009 were selected from the database. The patients underwent temporal lobectomy adjusted by electrocorticography (ECoG). The histopathological pattern, ictal video-EEG and intraoperative EcoG are described here.
Results: Of the 25 analyzed patients, 5 presented MRI neocortical structural lesions. One of them was an arachnoid cyst, a reason for its exclusion from the study. The histopathologic exam evidenced a patient with pilocytic astrocytoma, two ganglioglioma (GG) and a dysembryoplastic neuroepithelial tumour (DNT); the last one associated to a focal cortical dysplasia (FCD) type IA and IB. The seizure – type in these patients previous to surgery was partial complex. All cases were free of seizure until the last clinical evaluation.
Conclusions: The association of glioneuronal tumors is evidenced (GG and TND) with microscopic FCD in TLE patients. The temporal lobectomy adjusted by ECoG allowed to achieve the condition of no seizure in TLE patients / tumors of the neuroepithelial tissue, even in cases associated to FDC.
