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Invasive EEG in Tumoural Epilepsy 

Invasive EEG in Tumoural Epilepsy
Chapter:
Invasive EEG in Tumoural Epilepsy
Author(s):

Francine Chassoux

, Elisabeth Landré

, and Bertrand Devaux

DOI:
10.1093/med/9780198714668.003.0016
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date: 23 October 2019

Long-term epilepsy-associated tumours (LEATs) are usually dysembryoplastic neuroepithelial tumours (DNTs) and gangliogliomas. Both usually show childhood-onset intractable partial epilepsy, concordant focal EEG abnormalities, and predominant temporal location. Imaging showing typical pseudocystic pattern is suggestive of DNT. Gangliogliomas are characterized by association of a true cyst and nodular contrast enhancement. However, less typical patterns may also be seen, rendering differentiation between the two difficult. Stereo-EEG has demonstrated intrinsic epileptogenicity of both, the typical interictal pattern consisting of repetitive spikes on depressed background activity. Ictal onset discharges arise from tumour in all cases, spreading to peritumoural and secondarily distant areas. Intratumoural stimulations elicit seizures similar to spontaneous seizures. Hippocampus is involved early in most temporal tumours. Epileptogenic zone organization differs according to DNT subtypes, co-localized with tumour in simple and complex forms, and more extended in non-specific forms. In gangliogliomas, the epileptogenic zone is similar to that observed in non-specific DNTs.

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