Xie Mingguo, Wang Xiongfei, Duan Zejun, Luan Guoming
Department of Neurosurgery, Epilepsy Center, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Epilepsy, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Front Neurosci. 2023 Jan 9;16:1071314. doi: 10.3389/fnins.2022.1071314. eCollection 2022.
Brain tumors can always result in seizures when involving the cortical neurons or their circuits, and they were found to be one of the most common etiologies of intractable focal seizures. The low-grade epilepsy-associated neuroepithelial tumors (LEAT), as a special group of brain tumors associated with seizures, share common clinicopathological features, such as seizure onsets at a young age, a predilection for involving the temporal lobe, and an almost benign course, including a rather slow growth pattern and thus a long-term history of seizures. Ganglioglioma (GG) and dysembryoplastic neuroepithelial tumor (DNET) are the typical representatives of LEATs. Surgical treatments with complete resection of tumors and related epileptogenic zones are deemed the optimal way to achieve postoperative seizure control and lifetime recurrence-free survival in patients with LEATs. Although the term LEAT was originally introduced in 2003, debates on the tumor spectrum and the diagnosis or classification of LEAT entities are still confusing among epileptologists and neuropathologists. In this review, we would further discuss these questions, especially based on the updated classification of central nervous system tumors in the WHO fifth edition and the latest molecular genetic findings of tumor entities in LEAT entities.
脑肿瘤累及皮质神经元或其神经回路时总会引发癫痫发作,并且它们被发现是难治性局灶性癫痫最常见的病因之一。低度癫痫相关神经上皮肿瘤(LEAT)作为与癫痫相关的一类特殊脑肿瘤,具有共同的临床病理特征,如发病年龄较轻、倾向于累及颞叶以及几乎呈良性病程,包括生长模式相当缓慢以及因此有长期癫痫发作史。神经节细胞胶质瘤(GG)和胚胎发育不良性神经上皮肿瘤(DNET)是LEAT的典型代表。完全切除肿瘤及相关致痫区的手术治疗被认为是实现LEAT患者术后癫痫控制和终身无复发存活的最佳方法。尽管“LEAT”一词最初于2003年提出,但癫痫学家和神经病理学家对于LEAT实体的肿瘤谱以及诊断或分类仍存在争议。在本综述中,我们将进一步讨论这些问题,特别是基于世界卫生组织第五版中枢神经系统肿瘤的更新分类以及LEAT实体中肿瘤实体的最新分子遗传学发现。