Electrocorticographic–Histopathologic Correlations Implying Epileptogenicity of Dysembryoplastic Neuroepithelial Tumor
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概要
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Based on intracranial-video electroencephalography (EEG), histopathological features, and postoperative seizure outcome, we elucidated the epileptogenicity in patients with dysembryoplastic neuroepithelial tumor (DNT). Five patients (P1–P5) pathologically diagnosed with DNT underwent intracranial-video EEG to identify the ictal onset zone and irritative zone. We evaluated the correlations of ictal onset zone and irritative zone with the magnetic resonance imaging-visible lesion (MRI-lesion) and their histopathological features. Intracranial-video EEG located the ictal onset zone adjacent to the MRI-lesion margin in four patients with complex/simple forms of DNT subcategory, and on the MRI-lesion in P3 with a nonspecific DNT form. The irritative zone extended to surrounding regions of the ictal onset zone in all patients. Histopathologically, MRI-lesions were characterized by specific glioneuronal elements, whereas the ictal onset zone and irritative zone were represented with dysplastic cortex accompanying oligodendroglia-like cells in four (P1, P2, P4, and P5) of five patients. Cortical dysplasia was identified with typical histopathologic features in the irritative zone remote from the MRI-lesion in P5. P3, with a nonspecific form, indicated prominent component of dysplastic cortex with oligodendroglia-like cells scattered in the MRI-lesion. Lesionectomy of MRI-lesion with additional cortical resections (including the ictal onset zone and irritative zone) yielded postoperative seizure freedom (Engel Class I) in P3, P4, and P5, while P1 and P2 (with only lesionectomy) experienced postoperative residual seizure (Class II and III in each patient). Our results suggest the intrinsic epileptogenicity of DNT. The topographical correlation indicated that the dysplastic cortex accompanying oligodendroglia-like cells was more epileptogenic than the specific glioneuronal elements itself. Meticulous intracranial-video EEG analysis delineating the MRI nonvisible ictal onset zone and the irritative zone may yield better seizure outcome.
- 社団法人 日本脳神経外科学会の論文
著者
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Kurisu Kaoru
Department Of Neurosurgery
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Arita Kazunori
Department Of Earth And Planetary Sciences Hokkaido University
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Hashizume Akira
Department Of Neurosurgery Asahikawa Medical College
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Iida Koji
Department Of Applied Physics National Defence Academy
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Kakita Akiyoshi
Department Of Pathological Neuroscience (resource Branch For Brain Disease Research Cbbr) Brain Rese
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Arihiro Koji
Department Anatomical Pathology Hiroshima University Hospital
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Kiura Yoshihiro
Department Of Molecular And Pharmacological Neuroscience Graduate School Of Biomedical Sciences Hiro
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Hanaya Ryosuke
Department Of Neurosuegery Graduate School Of Biomedical Sciences Hiroshima University
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Kagawa Kota
Department Of Neurosurgery Hiroshima Prefectural Hospital Hiroshima
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Sugiyama Kazuhiko
Department Of Electronic Science And Engineering Kyoto University:crest Japan Science And Technology
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SUGIYAMA Kazuhiko
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
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HASHIZUME Akira
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
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KATAGIRI Masaya
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
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NISHIMOTO Takeshi
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
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KIURA Yoshihiro
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
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SUGIYAMA Kazuhiko
Department of Clinical Oncology and Neuro-oncology Program, Hiroshima University Hospital
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