Gliomas as Epileptogenic Lesions Investigated by CT scan

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  • グリオーマのてんかん原性に関するX線CT的研究

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Epileptic seizures are one of the most important symptoms of brain tumors, but the incidence of those differs depending upon many factors. The subjects in this report were 51 cases of supratentorial gliomas which consisted of 28 cases of glioblastomas and 23 cases of low grade astrocytomas. The authors analyzed the seizure occurences of the gliomas using CT scan with relation to the location, the degree of periforcal edema and the pattern of contrast enhancement.<BR>The gliomas located in the frontal or temporal lobe especially near the central sulcus had relatively high incidence of seizures. And, seizures occured more often with right-sided gliomas than with left-sided ones.<BR>The authors performed the grading of the extension of perifocal edema and found that the smaller was the extension of edema the higher was the incidence of seizures.<BR>Next, the authors divided the gliomas into four types according to the contrast enhancement effect of CT findings: marked ring enhancement type, slight ring enhancement type, nodular or irregular enhancement type and non-enhancement type. In glioblastomas marked ring enhancement type was most frequent, 13 of 28 cases, and only one of them had epileptic seizures. Most of glioblastomas with epileptic seizure were nodular or irregular enhancement type and non-enhancement type. In low grade astrocytomas 5 of 23 cases were marked ring enhancement type and none of them had epileptic seizures. Non-enhancement type was most frequent in low grade astrocytomas, 8 of 23 cases, and all of them had epileptic seizures. In comparison of CT and EEG findings, marked ring enhancement type showed the higher incidence of continuous slow waves than the other types did. And, non-enhancement type showed the higher incidence of paroxysmal discharges than the other types did. The results showed that the enhancement effects of CT findings reflected the degree of irritative effects of the gliomas to the brain tissue.

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