Epilepsy surgery without lipoma removal for temporal lobe epilepsy associated with lipoma in the Sylvian fissure

Epileptic seizure is the common symptom associated with lipomas in the Sylvian fissure (Sylvian lipomas). Removal of these lipomas carries risks of hemorrhage and brain damage. We report a surgical strategy of not removing the lipoma in a case of intractable temporal lobe epilepsy associated with Sy...

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Bibliographic Details
Published in:Acta neurochirurgica 2023-01, Vol.165 (1), p.265-269
Main Authors: Nomura, Kazuki, Suzuki, Hiroharu, Iimura, Yasushi, Mitsuhashi, Takumi, Tamrakar, Samantha, Ueda, Tetsuya, Nishioka, Kazuki, Fusegi, Keiko, Tada, Mari, Nakajima, Madoka, Kakita, Akiyoshi, Sugano, Hidenori
Format: Article
Language:English
Subjects:
Brain cancer
Brain injury
Brain Neoplasms - complications
Brain Neoplasms - diagnostic imaging
Brain Neoplasms - surgery
Case Report - Functional Neurosurgery - Epilepsy
Convulsions & seizures
Dysplasia
Electrodes
Electroencephalography
Epilepsy
Epilepsy, Temporal Lobe - diagnostic imaging
Epilepsy, Temporal Lobe - etiology
Epilepsy, Temporal Lobe - surgery
Functional Neurosurgery – Epilepsy
Hemorrhage
Humans
Interventional Radiology
Lipoma
Lipoma - complications
Lipoma - diagnostic imaging
Lipoma - surgery
Magnetic resonance imaging
Magnetic Resonance Imaging - adverse effects
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neocortex
Neurology
Neuroradiology
Neurosurgery
Seizures
Surgical Orthopedics
Surgical outcomes
Temporal lobe
Thoracic surgery
Tomography
Tumors
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Summary:Epileptic seizure is the common symptom associated with lipomas in the Sylvian fissure (Sylvian lipomas). Removal of these lipomas carries risks of hemorrhage and brain damage. We report a surgical strategy of not removing the lipoma in a case of intractable temporal lobe epilepsy associated with Sylvian lipoma. We performed anterior temporal lobectomy with preservation of the pia mater of the Sylvian fissure and achieved seizure freedom. Focal cortical dysplasia type 1 of the epileptic neocortex adjacent to the Sylvian lipoma was pathologically diagnosed. We recommend our surgical procedure in similar cases to avoid complications and achieve adequate seizure control.
ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-022-05330-7