Clinical characteristics and surgical results of temporal lobe tumors in children with epileptics seizures as initial symptom
Wang Difei, Zhai Xuan, Liang Ping, Li Lusheng, Zhou Yudong, Yu Zengpeng, Ji Wenyuan
Abstract
ObjectiveTo investigate the clinical features and surgical outcomes of temporal lobe tumors in children with epileptic seizures as initial symptom.
MethodsThe clinical data of 27 children with temporal lobe tumors and epileptic seizures as initial symptom who underwent surgery in the Neurosurgery Department of the Children′s Hospital of Chongqing Medical University from January 2013 to January 2020 were retrospectively analyzed. The children underwent clinical follow-up after operation, and the effect of seizure control was evaluated by the Engel grading standard. According to the pathological results, the patients were divided into benign tumor group[World Health Organization (WHO) grade Ⅰ] and malignant tumor group(WHO grade Ⅱ-Ⅳ). The general data and seizure outcomes of the two groups were compared.
ResultsTotal tumor resection was achieved in all 27 children, of whom 18 patients underwent lesion resection and standard anterior temporal lobectomy, and 9 underwent extended lesion resection. The pathological results revealed 5 cases of oligodendroglioma (WHO grade Ⅱ), 5 cases of dysembryoplastic neuroepithelial tumor (WHO grade Ⅰ), 4 cases of pilocytic astrocytoma (WHO grade Ⅰ), 4 cases of desmoplastic infantile astrocytoma and ganglioglioma (WHO grade Ⅰ), 4 cases of ependymoma (WHO grade Ⅱ), 3 cases of meningioma (WHO grade Ⅰ), 1 case of ganglioglioma (WHO grade Ⅰ) and 1 case of anaplastic ependymoma (WHO grade Ⅲ). All 27 children were followed up after operation, and the median follow-up time was 36 months (12-96 months). At the last follow-up, there were 21 cases (77.8%) of Engel grade Ⅰ, 5 cases (18.5%) of Engel grade Ⅱ, and 1 case (3.7%) of Engel grade Ⅲ. Compared with the malignant tumor group, the children in the benign tumor group were younger (P=0.040), and there were no statistical differences between the two groups in gender, epilepsy duration, tumor growth location in the temporal lobe, or postoperative outcome of seizure control (all P>0.05). The proportions of benign tumor group and malignant tumor group reaching Engel grade Ⅰ after operation were 14/17 and 7/10 respectively.
ConclusionsPreliminary observation has suggested that among the children with temporal lobe tumors and epileptic seizure as initial symptom who underwent surgical treatment, oligodendrocyte tumor and dysembryoplastic neuroepithelial tumor are most common. The tumors are mostly benign and malignant tumors are mostly low-grade. After surgical resection of the tumor, the postoperative effect of seizure control seems satisfactory.
Key words:
Brain neoplasms; Temporal lobe; Child; Epilepsy; Neurosurgical procedures; Treatment outcome
Contributor Information
Wang Difei
Department of Neurosurgery, Children′s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Developmental Disease Research, National Clinical Research Center for Child Health and Disease, National International Science and Technology Cooperation Base for Major Childhood Developmental Diseases, Chongqing Key Laboratory of Pediatrics, Chongqing 400015, China
Zhai Xuan
Department of Neurosurgery, Children′s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Developmental Disease Research, National Clinical Research Center for Child Health and Disease, National International Science and Technology Cooperation Base for Major Childhood Developmental Diseases, Chongqing Key Laboratory of Pediatrics, Chongqing 400015, China
Liang Ping
Department of Neurosurgery, Children′s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Developmental Disease Research, National Clinical Research Center for Child Health and Disease, National International Science and Technology Cooperation Base for Major Childhood Developmental Diseases, Chongqing Key Laboratory of Pediatrics, Chongqing 400015, China
Li Lusheng
Department of Neurosurgery, Children′s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Developmental Disease Research, National Clinical Research Center for Child Health and Disease, National International Science and Technology Cooperation Base for Major Childhood Developmental Diseases, Chongqing Key Laboratory of Pediatrics, Chongqing 400015, China
Zhou Yudong
Department of Neurosurgery, Children′s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Developmental Disease Research, National Clinical Research Center for Child Health and Disease, National International Science and Technology Cooperation Base for Major Childhood Developmental Diseases, Chongqing Key Laboratory of Pediatrics, Chongqing 400015, China
Yu Zengpeng
Department of Neurosurgery, Children′s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Developmental Disease Research, National Clinical Research Center for Child Health and Disease, National International Science and Technology Cooperation Base for Major Childhood Developmental Diseases, Chongqing Key Laboratory of Pediatrics, Chongqing 400015, China
Ji Wenyuan
Department of Neurosurgery, Children′s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Developmental Disease Research, National Clinical Research Center for Child Health and Disease, National International Science and Technology Cooperation Base for Major Childhood Developmental Diseases, Chongqing Key Laboratory of Pediatrics, Chongqing 400015, China
