Childhood Epilepsy with Medial Parietal Lobe Lesion (Precuneus and Posterior Cingulate Gyrus), Comparison of Two Cases

DOI 13 References
  • Magara Shin-ichi
    Department of Pediatric Neurology, National Center of Neurology and Psychiatry Department of Neurosurgery, National Center of Neurology and Psychiatry Department of Pediatrics, Nishi-Niigata Chuo National Hospital
  • Takahashi Akio
    Department of Neurosurgery, National Center of Neurology and Psychiatry
  • Saitoh Yoshiaki
    Department of Pediatric Neurology, National Center of Neurology and Psychiatry
  • Nakagawa Eiji
    Department of Pediatric Neurology, National Center of Neurology and Psychiatry
  • Kaidou Takanobu
    Department of Neurosurgery, National Center of Neurology and Psychiatry
  • Kaneko Yu
    Department of Neurosurgery, National Center of Neurology and Psychiatry
  • Sasaki Masayuki
    Department of Pediatric Neurology, National Center of Neurology and Psychiatry
  • Ohtsuki Taisuke
    Department of Neurosurgery, National Center of Neurology and Psychiatry

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Other Title
  • 頭頂葉内側（楔前部、帯状回後部）に病変を有する小児てんかん2例の比較検討

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We report two children with epilepsy due to tumors at medial parietal lobe (MPL). Patient 1 and 2 are right-handed boys, whose MRI showed tumors at right precuneus and posterior cingulate gyrus. They had seizures with tonic posturing resembling supplementary motor area seizures in common, but also experienced various other seizure types. The cortex neighboring the tumor were identified as epileptogenic zones by intracranial EEG evaluation in both patients. All areas of right MPL was resected in patient 1, and anterior right MPL was resected in patient 2. The seizure reduction rates were about 50% in patient 1 and 100% in patient 2. In post-operative evaluation, patient 1 showed remarkable decline in the score of "Block design" in WISC-III and his ability of copying solid figures was very poor, although patient 2 showed no abnormality in WISC-III after resection of MPL. Precuneus has been considered to have a role in visuo-spatial recognition and movement planning and the resection of almost all right MPL presumably had harmful effect for this ability in patient 1, in contrast to the preserved visuo-spatial cognition in patient 2 with spared posterior MPL.

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