engleski

Long-term epilepsy associated tumors

Brain tumors are the second most common cause of seizures identified in large epilepsy surgical series. Within the broad spectrum of brain tumors, specific types are more frequently associated with seizures which are called long-term epilepsy- associated tumors (LEATs). Most common LEATs are glioneuronal tumors, dysembryoplastic neuroepithelial tumors (DNET), and gangliogliomas (GG), but also papillary glioneuronal tumors, angiocentric glioma, isomorphic diffuse glioma, multinodular and vacuolating neuronal tumors of the cerebrum and polymorphous low-grade neuroepithelial tumor. LEATs are regularly treated by surgical resection with seizure-free rates ranging from 77% to 93% for DNETs and 63% to 100% for GGs. Although LEATs are predominantly benign tumors, sometimes seizures are refractory to antiepileptic treatments, resulting in drug- resistant tumor-related epilepsy, long-term disability, and patient morbidity with a profound impact on quality of life. Common features of LEATs are seizure onset at a young age (<18 years), focal epilepsy with seizure semiology related to the localization of the lesion and the patient's age, localization predominately in the temporal lobe, broad histomorphological spectrum, rare malignant progression, and rare focal neurological signs. Recent developments towards further understanding of the molecular and devel- opmental backgrounds of specific LEATS have been achieved and new genes associated with LEAT have been also reported (BRAF V600E mutations to GG with CD34 expression, FGFRI mutations to DNT, etc.) that could lead to the development of new tumor classification scheme. The author will present experience and challenges in treating patients with LEAT in the Referral Centre for Epilepsy of the University Hospital Centre Zagreb.

epilepsy, brain tumor

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