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ID 36260
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title alternative
胚芽異形成性神経上皮腫瘍におけるてんかん原性領域を意味する頭蓋内脳波所見と組織所見の相関性
creator
Kagawa, Kota
subject
dysembryoplastic neuroepithelial tumor (DNT)
epileptogenicity
epilepsy surgery
intracranial electroencephalography (EEG)
histopathology
NDC
Medical sciences
abstract
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 oligodendroglialike 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 MRIlesion. 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.
date of created
2014-11-21
language
eng
nii type
Thesis or Dissertation
HU type
Doctoral Theses
DCMI type
text
format
application/pdf
text version
ETD
rights
Copyright(c) by Author
relation references
Kota Kagawa, Koji Iida, Akiyoshi Kakita, Masaya Katagiri, Takeshi Nishimoto, Akira Hashizume, Yoshihiro Kiura, Ryosuke Hanaya, Kazuhiko Sugiyama, Koji Arihiro, Kazunori Arita and Kaoru Kurisu; Electrocorticographic-Histopathologic Correlations Implying Epileptogenicity of Dysembryoplastic Neuroepithelial Tumor; Neurologia medico-chirurgica, Vol. 53 (2013) No. 10 p. 676-687 (doi: 10.2176/nmc.oa2012-0420)
relation references URL
http://dx.doi.org/10.2176/nmc.oa2012-0420
grantid
甲第6192号
degreeGrantor
広島大学(Hiroshima University)
degreename Ja
博士(医学)
degreename En
Philosophy in Medical Science
degreelevel
doctoral
date of granted
2013-05-23
department
Graduate School of Biomedical Science