Evaluation, surgical approach and outcome of seizure patients with gangliogliomas.
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A retrospective study of 15 children with intracranial gangliogliomas and intractable seizures revealed that tumors associated with seizure were located in the temporal and frontal lobes. These patients underwent lobectomy under electrocorticography. Mesial temporal sclerosis was identified in the hippocampus of the excised temporal lobe in 7 of 13 patients with temporal lobectomies. Eleven of the 15 children were seizure-free over a mean follow-up period of 4 years. The surgical approach to gangliogliomas requires careful pre-operative evaluation, including neuroimaging and electrophysiological study to locate seizure activity. Removal of epileptogenic brain as well as the ganglioglioma is recommended to optimize seizure control.