Epilepsy in Five Long-term Survivors of Pineal Region Tumors

DOI Web Site 参考文献31件
  • TAKAYAMA Yutaro
    Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • JIN Kazutaka
    Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
  • OSAWA Shin-ichiro
    Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
  • IWASAKI Masaki
    Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
  • UKISHIRO Kazushi
    Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • KAKISAKA Yosuke
    Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
  • TOMINAGA Teiji
    Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
  • YAMAMOTO Tetsuya
    Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
  • NAKASATO Nobukazu
    Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan

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<p>Cognitive decline is a well-known chronic side effect of multidisciplinary treatment of pineal region tumors, whereas epilepsy is an under-reported chronic consequence caused by multiple potential factors including radiotherapy, surgery, or chemotherapy. Some long-term survivors have suffered drug-resistant epilepsy after treatment, which impaired the quality of life. We report five consecutive patients with drug-resistant epilepsy after combined treatment of pineal region tumor (5 men, aged 21–42 years) among 1201 epilepsy patients who underwent comprehensive evaluation in our tertiary epilepsy center from 2011 to 2018. The comprehensive epilepsy evaluation included medical interview, long-term video electroencephalography (EEG) monitoring (VEM), and magnetic resonance (MR) imaging. The patients started to have seizures at 2–22 years after initial treatment for the tumor. Four of the five patients had focal impaired awareness seizures, whereas one patient had only visual aura. All patients had EEG seizures during VEM, which confirmed the diagnosis of focal epilepsy, but three patients had no interictal epileptiform discharges (IEDs). Two patients had diagnoses of focal epilepsy arising from the left occipital region based on ictal EEG findings. Both patients had MR imaging lesion in the left occipital lobe, radiation-induced cavernoma, or surgical injury. The remaining three patients showed poor localization of epileptogenic foci based on VEM and MR imaging. Drug-resistant epilepsy after multidisciplinary treatment of pineal region tumor is characterized by focal impaired awareness seizures with poorly localized EEG onset or rare interictal spikes.</p>

収録刊行物

  • NMC Case Report Journal

    NMC Case Report Journal 8 (1), 773-780, 2021

    一般社団法人 日本脳神経外科学会

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