Review
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World J Clin Cases. Nov 16, 2014; 2(11): 623-641
Published online Nov 16, 2014. doi: 10.12998/wjcc.v2.i11.623
Epilepsy associated tumors: Review article
Marco Giulioni, Gianluca Marucci, Matteo Martinoni, Anna Federica Marliani, Francesco Toni, Fiorina Bartiromo, Lilia Volpi, Patrizia Riguzzi, Francesca Bisulli, Ilaria Naldi, Roberto Michelucci, Agostino Baruzzi, Paolo Tinuper, Guido Rubboli
Marco Giulioni, Matteo Martinoni, IRCCS Institute of Neurological Sciences of Bologna, Division of Neurosurgery, Bellaria Hospital, 40139 Bologna, Italy
Gianluca Marucci, Department of Biomedical and Neuromotor Sciences (DiBiNeM), Section of Pathology “M.Malpighi”, Bellaria Hospital, University of Bologna, 40139 Bologna, Italy
Anna Federica Marliani, Francesco Toni, IRCCS Institute of Neurological Sciences of Bologna, Section of Neuroradiology, Bellaria Hospital, 40139 Bologna, Italy
Fiorina Bartiromo, Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Section of Neuroradiology, University of Bologna, 40139 Bologna Italy
Lilia Volpi, Patrizia Riguzzi, Roberto Michelucci, Guido Rubboli, IRCCS Institute of Neurological Sciences of Bologna, Division of Neurology, Bellaria Hospital, 40139 Bologna, Italy
Francesca Bisulli, Ilaria Naldi, Agostino Baruzzi, Paolo Tinuper, IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, 40139 Bologna, Italy
Francesca Bisulli, Agostino Baruzzi, Paolo Tinuper, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40139 Bologna Italy
Guido Rubboli, Danish Epilepsy Centre, Epilepsi hospitalet, 4293 Dianalund, Denmark
Author contributions: Giulioni M, Marucci G, Martinoni M drafted the article; Giulioni M, Marucci G, Martinoni M, Marliani AF, Toni F, Bartiromo F, Volpi L, Riguzzi P, Bisulli F, Naldi I, Michelucci R, Baruzzi A, Tinuper P and Rubboli G contributed to data analysis, to separate heading of the article and to revised the article.
Correspondence to: Marco Giulioni, MD, IRCCS Institute of Neurological Sciences, Division of Neurosurgery, Bellaria Hospital, Via Altura 1/8, 40139 Bologna, Italy. giulioni.m@tiscali.it
Telephone: +39-051-6225111 Fax: +39-051-6225347
Received: July 29, 2014
Revised: September 17, 2014
Accepted: October 1, 2014
Published online: November 16, 2014
Processing time: 104 Days and 11.4 Hours
Abstract

Long-term epilepsy associated tumors (LEAT) represent a well known cause of focal epilepsies. Glioneuronal tumors are the most frequent histological type consisting of a mixture of glial and neuronal elements and most commonly arising in the temporal lobe. Cortical dysplasia or other neuronal migration abnormalities often coexist. Epilepsy associated with LEAT is generally poorly controlled by antiepileptic drugs while, on the other hand, it is high responsive to surgical treatment. However the best management strategy of tumor-related focal epilepsies remains controversial representing a contemporary issues in epilepsy surgery. Temporo-mesial LEAT have a widespread epileptic network with complex epileptogenic mechanisms. By using an epilepsy surgery oriented strategy LEAT may have an excellent seizure outcome therefore surgical treatment should be offered early, irrespective of pharmacoresistance, avoiding both the consequences of uncontrolled seizures as well as the side effects of prolonged pharmacological therapy and the rare risk of malignant transformation.

Keywords: Epilepsy; Low grade tumors; Long-term epilepsy associated tumors; Glioneuronal tumors; Ganglioglioma; Dysembryoplastic neuroepithelial tumor; Lesionectomy; Epilepsy surgery

Core tip: Long-term epilepsy associated tumors (LEAT) represent a frequent cause of focal epilepsies, particularly in children and young adults. Epilepsy associated with LEAT is generally poorly controlled by antiepileptic drugs while it is extremely responsive to surgical treatment. Temporo-mesial LEAT have a widespread epileptic network and complex epileptogenic mechanisms. The best management strategy of tumor-related focal epilepsies remains controversial representing a contemporary issues in epilepsy surgery.