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Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—A review of surgical outcomes across several studies
PURPOSE: In children and adolescents, dysembryoplastic neuroepithelial tumors (DNETs) of the brain present with seizures almost 100 % of the time, potentially creating significant long-term morbidity and disability despite the generally indolent course of the lesion. These tumors also tend to be qui...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445255/ https://www.ncbi.nlm.nih.gov/pubmed/25795072 http://dx.doi.org/10.1007/s00381-015-2675-9 |
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author | Ranger, Adrianna Diosy, David |
author_facet | Ranger, Adrianna Diosy, David |
author_sort | Ranger, Adrianna |
collection | PubMed |
description | PURPOSE: In children and adolescents, dysembryoplastic neuroepithelial tumors (DNETs) of the brain present with seizures almost 100 % of the time, potentially creating significant long-term morbidity and disability despite the generally indolent course of the lesion. These tumors also tend to be quite resistant to anti-epileptic drugs which, themselves, can be associated with long-term side effects and resultant disability. Many clinicians advocate early surgical resection of these lesions, but how effective this approach is, and how aggressive tumor removal should be, continues to be debated. METHODS: We performed a systematic review of the relevant literature to identify all reports of DNET resections in pediatric patients published over the past 20 years. In all, over 3000 MEDLINE abstracts were reviewed, ultimately resulting in 13 studies with 185 pediatric DNET patients to review. RESULTS: Surgical resection of the lesion was effective at improving seizures in over 98 % of patients and at achieving long-term seizure freedom in 86 %. Surgical resection of DNETs also appeared to be quite safe, with no reported perioperative deaths and an overall rate of postoperative complications of 12 %; the vast majority of these complications were transient. CONCLUSIONS: Total gross resection of the lesion was the only factor statistically correlated with long-term seizure freedom (r = 0.63, p = 0.03). However, data remain lacking regarding whether this translates into more extensive procedures—like brain mapping and partial lobectomies—being any more effective than simple lesionectomies alone. Further research is clearly needed to address this and other crucial questions. |
format | Online Article Text |
id | pubmed-4445255 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-44452552015-06-01 Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—A review of surgical outcomes across several studies Ranger, Adrianna Diosy, David Childs Nerv Syst Review Paper PURPOSE: In children and adolescents, dysembryoplastic neuroepithelial tumors (DNETs) of the brain present with seizures almost 100 % of the time, potentially creating significant long-term morbidity and disability despite the generally indolent course of the lesion. These tumors also tend to be quite resistant to anti-epileptic drugs which, themselves, can be associated with long-term side effects and resultant disability. Many clinicians advocate early surgical resection of these lesions, but how effective this approach is, and how aggressive tumor removal should be, continues to be debated. METHODS: We performed a systematic review of the relevant literature to identify all reports of DNET resections in pediatric patients published over the past 20 years. In all, over 3000 MEDLINE abstracts were reviewed, ultimately resulting in 13 studies with 185 pediatric DNET patients to review. RESULTS: Surgical resection of the lesion was effective at improving seizures in over 98 % of patients and at achieving long-term seizure freedom in 86 %. Surgical resection of DNETs also appeared to be quite safe, with no reported perioperative deaths and an overall rate of postoperative complications of 12 %; the vast majority of these complications were transient. CONCLUSIONS: Total gross resection of the lesion was the only factor statistically correlated with long-term seizure freedom (r = 0.63, p = 0.03). However, data remain lacking regarding whether this translates into more extensive procedures—like brain mapping and partial lobectomies—being any more effective than simple lesionectomies alone. Further research is clearly needed to address this and other crucial questions. Springer Berlin Heidelberg 2015-03-21 2015 /pmc/articles/PMC4445255/ /pubmed/25795072 http://dx.doi.org/10.1007/s00381-015-2675-9 Text en © The Author(s) 2015 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Review Paper Ranger, Adrianna Diosy, David Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—A review of surgical outcomes across several studies |
title | Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—A review of surgical outcomes across several studies |
title_full | Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—A review of surgical outcomes across several studies |
title_fullStr | Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—A review of surgical outcomes across several studies |
title_full_unstemmed | Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—A review of surgical outcomes across several studies |
title_short | Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—A review of surgical outcomes across several studies |
title_sort | seizures in children with dysembryoplastic neuroepithelial tumors of the brain—a review of surgical outcomes across several studies |
topic | Review Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445255/ https://www.ncbi.nlm.nih.gov/pubmed/25795072 http://dx.doi.org/10.1007/s00381-015-2675-9 |
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