Division of Neurosurgery, IRCCS, Bellaria Hospital, Bologna, Italy.
Panminerva Med. 2013 Jun;55(2):225-38.
Glioneuronal tumors (GNTs) are an increasingly recognized cause of focal epilepsies, particularly in children and young adults. GNTs consist of a mixture of glial and neuronal elements and most commonly arise in the temporal lobe, particularly in the temporo-anterior-basal mesial site. They are often associated with cortical dysplasia or other neuronal migration abnormalities. Epilepsy associated with GNT is poorly controlled by antiepileptic drugs in many cases; but, it is extremely responsive to surgical treatment. However, the best management strategy of tumor-related focal epilepsies remains controversial and still remain one of the contemporary issues in epilepsy surgery. Temporo-mesial GNT are associated with a widespread epileptic network, defining, therefore, a distinct anatomo-clinico-pathological group with complex epileptogenic mechanisms. By using an epilepsy surgery oriented strategy GNT associated with focal epilepsies may have an excellent seizure outcome and, therefore, surgical treatment can be offered early to avoid both the consequences of uncontrolled seizures as well as the side effects of prolonged pharmacological therapy and the rare risk of tumor growth or malignant transformation.
胶质神经元肿瘤（GNTs）是局灶性癫痫的一种越来越被认可的病因，尤其在儿童和青年中。GNTs 由胶质和神经元成分混合组成，最常发生在颞叶，特别是颞前基底内侧部位。它们通常与皮质发育不良或其他神经元迁移异常有关。在许多情况下，抗癫痫药物对与 GNT 相关的癫痫控制不佳；但手术治疗非常有效。然而，肿瘤相关局灶性癫痫的最佳治疗策略仍存在争议，仍是癫痫手术中的当代问题之一。颞内侧 GNT 与广泛的癫痫网络相关，因此定义了具有复杂致痫机制的独特解剖学-临床-病理组。通过使用以癫痫手术为导向的策略，与局灶性癫痫相关的 GNTs 可能有极好的癫痫发作结果，因此可以早期进行手术治疗，以避免不受控制的癫痫发作的后果以及长期药物治疗的副作用和肿瘤生长或恶性转化的罕见风险。
