Kodama Satoshi, Shirota Yuichiro, Hagiwara Akifumi, Otsuka Juuri, Sato Kazuya, Sugiyama Yusuke, Mori Harushi, Watanabe Masako, Hamada Masashi, Toda Tatsushi
Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Clin Neurophysiol Pract. 2019 Jul 16;4:164-167. doi: 10.1016/j.cnp.2019.05.003. eCollection 2019.
Multinodular and vacuolating neuronal tumor (MVNT) had been initially described as an epilepsy-related brain tumor, but recent studies demonstrated it could be found incidentally in non-epilepsy patients.
A 33-year-old woman with intractable post-encephalitis epilepsy presented a cluster of multinodular T2 hyperintensity in the left temporal lobe, which was very similar to the characteristics of MVNT. Long-term video electroencephalogram demonstrated that the habitual seizures were originated from bilateral temporal area and the interictal epileptic discharges were seen multifocally, although the lesions with MVNT appearance were localized in the left temporal lobe. It was presumed that the epilepsy in this patient was due to encephalitis in the past, and the link between the lesions and the epilepsy in this patient seemed weak.
Although MVNT had been considered as an epilepsy-related brain tumor, we suggest it is not necessarily preferable to perform surgical resection of MVNT even on patients with epilepsy, unless epileptic foci are highly related to MVNT.
多结节空泡状神经元肿瘤(MVNT)最初被描述为一种与癫痫相关的脑肿瘤,但最近的研究表明它也可能在非癫痫患者中偶然发现。
一名33岁患有难治性脑炎后癫痫的女性,其左侧颞叶出现一簇多结节性T2高信号,这与MVNT的特征非常相似。长期视频脑电图显示,习惯性癫痫发作起源于双侧颞区,发作间期癫痫放电呈多灶性,尽管具有MVNT表现的病变局限于左侧颞叶。推测该患者的癫痫是既往脑炎所致,病变与该患者癫痫之间的联系似乎较弱。
尽管MVNT被认为是一种与癫痫相关的脑肿瘤,但我们建议,即使对于癫痫患者,除非癫痫病灶与MVNT高度相关,否则不一定首选对MVNT进行手术切除。