1
|
Cai Y, Yang W, Peng X, Yuan L, Ge M. Experience in treating children with ocular dyskinesia and hemifacial spasm secondary to pontine tumours adjacent to the fourth ventricle and systematic review. Childs Nerv Syst 2024; 40:1349-1360. [PMID: 38227027 DOI: 10.1007/s00381-024-06280-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVE To investigate the treatment plan and prognosis of children with ocular dyskinesia and hemifacial spasm secondary to pontine tumours adjacent to the fourth ventricle. METHODS In this retrospective study, the clinical information of 10 consecutively collected children with ocular dyskinesia and hemifacial spasm secondary to pontine tumours adjacent to the fourth ventricle was analyzed. All 10 children underwent pontine tumour resection through a trans-cerebellomedullary fissure approach; 4 children underwent preoperative diffusion tensor imaging scans to determine the relationship between the tumour and facial nerve nucleus, and the other 6 children underwent intraoperative deep electroencephalography (EEG) tumour monitoring, in which the tumour electrical discharge activity of the tumour was recorded. A voxel distribution map was established to describe the distribution of the tumour location, and patient prognosis was evaluated through clinical and imaging follow-up. RESULTS All 10 children achieved total tumour resection; 9 tumours were pathologically suggested to be ganglioglioma (WHO grade I), and 1 was a hamartoma. The symptoms of the original ocular dyskinesia and hemifacial spasm disappeared immediately after the operation. The children were followed up for 4-75 months, and none of the symptoms recurred; four cases with preoperative diffusion tensor imaging showed that the tumour was close to the facial nerve. Four in six intraoperative electrophysiological monitoring showed that the tumour had electrical discharge behaviour, and the tumour distribution map indicates a high density of tumour presence in the facial nerve nucleus and the nucleus of the abducens nerve. CONCLUSIONS In paediatric patients, the facial symptoms are related to the location and abnormal electrical discharge of the tumour. There is no significant correlation between ocular dyskinesia and the location of the tumour. Conventional antiepileptic therapy for this disease is ineffective, and early surgical intervention for total tumour resection can achieve a clinical curative effect.
Collapse
Affiliation(s)
- Yingjie Cai
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishilu, West District, Beijing, 100045, China
| | - Wei Yang
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishilu, West District, Beijing, 100045, China
| | - Xiaojiao Peng
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishilu, West District, Beijing, 100045, China
| | - Liu Yuan
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishilu, West District, Beijing, 100045, China
| | - Ming Ge
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishilu, West District, Beijing, 100045, China.
| |
Collapse
|
2
|
Possible contribution of cerebellar disinhibition in epilepsy. Epilepsy Behav 2021; 118:107944. [PMID: 33887658 DOI: 10.1016/j.yebeh.2021.107944] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We hypothesize that loss of inhibition from the cerebellum can lead to cortical activation and seizures. BACKGROUND The traditional model for development of seizures purports that the source of seizures is increased electrical activity originating from cerebral cortical neurons. Studies have shown a decrease in inhibition results in a shift of cortical activity to a hyperexcitable state, which may lead to seizures. Interestingly, a 1978 study suggested the term "disorder of disinhibition" as a way to describe epilepsy from studies of chronic cerebellar stimulation. DESIGN/METHODS Cases and experimental studies in which cerebellar lesions have been implicated in the development of seizures were reviewed. Cases in which cerebellar inhibition has been targeted in the treatment of seizures were also included. Twenty-six studies and case reports are presented for this report. RESULTS The cases show cerebellar lesions can lead to cortical epileptiform activity. Purkinje cell loss is linked to the occurrence of seizures in animals. The majority of patients with cerebellar lesions were seizure free after complete resection, while less than half of patients were seizure free after partial resection. Novel treatments using deep-brain stimulation targeting cerebellar structures demonstrated therapeutic benefits for seizures. CONCLUSIONS Although pathophysiology is not well-understood, the cerebellum likely plays an inherent role in inhibiting aberrant cortical epileptogenesis. Cerebellar lesions may cause seizures due to loss of the inhibition of cortical areas or through intrinsic epileptic activity. Treatments enhancing cerebellar stimulation have shown therapeutic benefits in treating seizures, which could potentially provide another avenue for treatment.
Collapse
|
3
|
Tish S, Habboub G, Prayson RA, Woodard TD, Kshettry VR, Recinos PF. Extraventricular neurocytoma with ganglioid differentiation of the sellar and parasellar regions in an elderly patient: A case report. Surg Neurol Int 2019; 10:82. [PMID: 31528420 PMCID: PMC6744785 DOI: 10.25259/sni-30-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/21/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Extraventricular neurocytoma (EVN) is a rare variant of central neurocytoma which arises outside of the ventricular system. Diffuse ganglioid differentiation is a characteristic seen in a subset of these tumors which has an uncertain prognostic significance. Typically, EVN presents in children and young adults. Given the rarity of this tumor, the natural history and response to treatments remain unclear. Case Description: We present a case of EVN with diffuse ganglioid differentiation in a 70-year-old male which arose in the midline parasellar region and extended into the third ventricle. This is the oldest such patient reported. Despite prior reports that extremes of age are associated with more aggressive behavior, the tumor in this case did not exhibit such an aggressive course. Conclusion: In this report, we review the natural history and clinical course of this patient and summarize the literature regarding this rare pathological entity. Our patient responded well to therapy despite older age, ganglioid differentiation, and higher mitotic index.
Collapse
Affiliation(s)
- Shahed Tish
- Minimally-Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic Section of Skull Base Surgery, Ohio, United States
| | - Ghaith Habboub
- Section of Skull Base Surgery, Department of Neurological Surgery, Cleveland Clinic, Ohio, United States
| | - Richard A Prayson
- Department of Anatomic Pathology, Cleveland Clinic, Ohio, United States
| | - Troy D Woodard
- Minimally-Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic Section of Skull Base Surgery, Ohio, United States.,Section of Rhinology, Sinus, and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Varun R Kshettry
- Minimally-Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic Section of Skull Base Surgery, Ohio, United States.,Section of Skull Base Surgery, Department of Neurological Surgery, Cleveland Clinic, Ohio, United States
| | - Pablo F Recinos
- Minimally-Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic Section of Skull Base Surgery, Ohio, United States.,Section of Skull Base Surgery, Department of Neurological Surgery, Cleveland Clinic, Ohio, United States.,Section of Rhinology, Sinus, and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, United States
| |
Collapse
|
4
|
Tish S, Habboub G, Jones J, Ostrom QT, Kruchko C, Barnholtz-Sloan JS, Recinos PF, Kshettry VR. The epidemiology of central and extraventricular neurocytoma in the United States between 2006 and 2014. J Neurooncol 2019; 143:123-127. [DOI: 10.1007/s11060-019-03144-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/04/2019] [Indexed: 11/28/2022]
|
5
|
Cai Y, Ge M, Qi X, Sun H, Zhang D. Ocular Dyskinesia and Hemifacial Spasm Secondary to Fourth Ventricular Tumor: Report of 4 Cases and Review of the Literature. Pediatr Neurosurg 2019; 54:359-366. [PMID: 31437843 DOI: 10.1159/000501915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/03/2019] [Indexed: 11/19/2022]
Abstract
In clinical pediatric neurosurgery practice, fourth ventricle and cerebellar tumors are not rare. However, reports of secondary refractory hemifacial spasm are very rare. No report is currently available on the treatment of hemifacial spasm secondary to fourth ventricle and cerebellar tumors in China. Zamponi et al. [Childs Nerv Syst 2011 Jun;27(6):1001-5] reported that these lesions can occur in neonates and infants, and surgical resection is effective.
Collapse
Affiliation(s)
- Yingjie Cai
- Department of Neurosurgical, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ming Ge
- Department of Neurosurgical, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China,
| | - Xiang Qi
- Department of Neurosurgical, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hailang Sun
- Department of Neurosurgical, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Di Zhang
- Department of Neurosurgical, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| |
Collapse
|
6
|
Dysplastic Cerebellar Epilepsy: Complete Seizure Control Following Resection of a Ganglioglioma. THE CEREBELLUM 2017. [PMID: 26208704 DOI: 10.1007/s12311-015-0705-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Subcortical epilepsy has been a controversial issue, partially settled by evidence showing seizure generation in hypothalamic hamartomas and also by reports of seizures caused by cerebellar lesions. We report 4-year-old girl with right hemifacial seizures and autonomic phenomena, in whom MRI showed an irregular mass in the right cerebellar peduncle. Despite several unremarkable video-EEG recordings, seizure origin in the lesion was hypothesized. Complete resection was feasible, histopathology showed a ganglioglioma, and she has been seizure free for 3 years. A fine line separates these developmental tumors from focal cortical dysplasia, and the homogeneous presentation of this entity led us to propose the terminology dysplastic cerebellar epilepsy.
Collapse
|
7
|
Facial spasms, but not hemifacial spasm: a case report and review of literature. Childs Nerv Syst 2016; 32:1735-9. [PMID: 26984806 DOI: 10.1007/s00381-016-3057-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 03/06/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Facial spasms represent a complicated array of neurological motor disorders with unique diagnostic and treatment algorithms. Due to the rarity of many of these disorders in the pediatric population, special care must be taken in identifying subtle differences in presentation of these disorders. METHODS We present a case of a 3-year-old boy diagnosed with a brainstem ganglioglioma, Chiari 1 malformation, and a 2-year history of left-sided facial spasms. Stereotyped facial contractions and subtle eye deviation occurred every 10 s, with downward movement rather than upward elevation of the eyebrow. RESULTS MRI revealed absence of a clear compressive vessel of the centrally-myelinized portion of the facial nerve, and EMG of the left facial nerve demonstrated no abnormal motor response or evidence of "lateral spread." Given these findings, a diagnosis of hemifacial seizures was made. Microvascular decompression was not recommended, and botulinum toxin injection was not pursued; however, the patient has remained refractory to antiepileptic drugs, possibly due to biochemical alteration by his ganglioglioma. He may eventually require surgical debulking should his symptoms progress. CONCLUSION Hemifacial spasm is a well-recognized disorder, but similar conditions can, at times, imitate its appearance. While our patient presented with facial spasms, his clinical history, examination, and radiographic and electrophysiological findings were more consistent with hemifacial seizures secondary to a brainstem lesion, rather than hemifacial spasms. It is important to distinguish the two entities, as misdiagnosis and inappropriate diagnostic or therapeutic measures may be taken inadvertently.
Collapse
|
8
|
Marcián V, Filip P, Bareš M, Brázdil M. Cerebellar Dysfunction and Ataxia in Patients with Epilepsy: Coincidence, Consequence, or Cause? TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2016; 6:376. [PMID: 27375960 PMCID: PMC4925921 DOI: 10.7916/d8kh0nbt] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 05/05/2016] [Indexed: 12/15/2022]
Abstract
Basic epilepsy teachings assert that seizures arise from the cerebral cortex, glossing over infratentorial structures such as the cerebellum that are believed to modulate rather than generate seizures. Nonetheless, ataxia and other clinical findings in epileptic patients are slowly but inevitably drawing attention to this neural node. Tracing the evolution of this line of inquiry from the observed coincidence of cerebellar atrophy and cerebellar dysfunction (most apparently manifested as ataxia) in epilepsy to their close association, this review considers converging clinical, physiological, histological, and neuroimaging evidence that support incorporating the cerebellum into epilepsy pathology. We examine reports of still controversial cerebellar epilepsy, studies of cerebellar stimulation alleviating paroxysmal epileptic activity, studies and case reports of cerebellar lesions directly associated with seizures, and conditions in which ataxia is accompanied by epileptic seizures. Finally, the review substantiates the role of this complex brain structure in epilepsy whether by coincidence, as a consequence of deleterious cortical epileptic activity or antiepileptic drugs, or the very cause of the disease.
Collapse
Affiliation(s)
- Václav Marcián
- First Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic; Medical Faculty of Masaryk University, Brno, Czech Republic.,First Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic; Medical Faculty of Masaryk University, Brno, Czech Republic; Behavioral and Social Neuroscience Research Group, CEITEC (Central European Institute of Technology), Masaryk University, Brno, Czech Republic; Department of Neurology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Pavel Filip
- First Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic; Medical Faculty of Masaryk University, Brno, Czech Republic
| | - Martin Bareš
- First Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic; Medical Faculty of Masaryk University, Brno, Czech Republic; Behavioral and Social Neuroscience Research Group, CEITEC (Central European Institute of Technology), Masaryk University, Brno, Czech Republic; Department of Neurology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Milan Brázdil
- First Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic; Medical Faculty of Masaryk University, Brno, Czech Republic; Behavioral and Social Neuroscience Research Group, CEITEC (Central European Institute of Technology), Masaryk University, Brno, Czech Republic
| |
Collapse
|
9
|
Lesional cerebellar epilepsy: a review of the evidence. J Neurol 2016; 264:1-10. [PMID: 27260293 DOI: 10.1007/s00415-016-8161-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/03/2016] [Accepted: 05/04/2016] [Indexed: 10/21/2022]
Abstract
Classical teaching in epileptology localizes the origins of focal seizures solely in the cerebral cortex, with only inhibitory effects attributed to subcortical structures. However, electrophysiological and neuroimaging studies over the last decades now provide evidence for an initiation of epileptic seizures within subcortical structures. Intrinsic epileptogenicity of hypothalamic hamartoma has already been established in recognition of subcortical epilepsy, whereas a seizure-generating impact of dysplastic cerebellar lesions remains to be clarified. Herein, we examine the supportive evidence and clinical presentation of cerebellar seizures and review therapy options.
Collapse
|
10
|
Bonney PA, Boettcher LB, Krysiak RS, Fung KM, Sughrue ME. Histology and molecular aspects of central neurocytoma. Neurosurg Clin N Am 2015; 26:21-9. [PMID: 25432180 DOI: 10.1016/j.nec.2014.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Central neurocytoma (CN) is a well-differentiated tumor of neural cells occurring within the ventricles. It is composed of monomorphic cells with round, regular nuclei within clear cytoplasm and must be distinguished from other clear cell tumors. Immunohistochemical markers of CN that aid in diagnosis include synaptophysin and neuronal nuclear antigen. The molecular biology of these tumors is becoming increasingly elucidated, particularly with the use of microarray analyses. Several oncogenic pathways have been suggested by these studies. Although progress continues to be made, knowledge of CN has yet to dictate targeted therapies in treating patients with these tumors.
Collapse
Affiliation(s)
- Phillip A Bonney
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 North Lincoln Boulevard, Suite 4000, Oklahoma City, OK 73104, USA
| | - Lillian B Boettcher
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 North Lincoln Boulevard, Suite 4000, Oklahoma City, OK 73104, USA
| | - Richard S Krysiak
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 North Lincoln Boulevard, Suite 4000, Oklahoma City, OK 73104, USA
| | - Kar-Ming Fung
- Department of Pathology, University of Oklahoma Health Sciences Center, 940 Stanton L. Young Boulevard, BMSB 451, Oklahoma City, OK 73104, USA
| | - Michael E Sughrue
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 North Lincoln Boulevard, Suite 4000, Oklahoma City, OK 73104, USA; Oklahoma Comprehensive Brain Tumor Clinic, Oklahoma City, OK 73104, USA.
| |
Collapse
|
11
|
Sabatino G, Della Pepa GM, Albanese A, Lauriola L, Marchese E. Cystic ganglioneurocytoma of the lateral ventricles. Br J Neurosurg 2014; 28:688-90. [DOI: 10.3109/02688697.2014.881462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
12
|
Tracking the source of cerebellar epilepsy: Hemifacial seizures associated with cerebellar cortical dysplasia. Epilepsy Res 2013; 105:245-9. [DOI: 10.1016/j.eplepsyres.2012.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 11/29/2012] [Accepted: 12/01/2012] [Indexed: 11/18/2022]
|
13
|
Specchio N, Trivisano M, Bernardi B, Marras CE, Faggioli R, Fiumana E, Cappelletti S, Delalande O, Vigevano F, Fusco L. Neonatal hemifacial spasm and fourth ventricle mass. Dev Med Child Neurol 2012; 54:697-703. [PMID: 22548445 DOI: 10.1111/j.1469-8749.2012.04247.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Congential hemifacial spasm is a rare condition that is characterized by the occurrence of paroxysmal hemifacial contractions in neonates. We review the clinical, neurophysiological, neuroimaging, and histopathological findings, as well as the differential diagnosis, therapeutic approach, and outcome of all the described cases. Moreover, we report two new cases including the ictal video-electroencephalography recordings. Hemifacial spasm starts early in life, and is characterized by unilateral, involuntary, irregular tonic or clonic contractions of muscles innervated by the seventh cranial nerve. Hemifacial spasm is associated with eyelid blinking, and sometimes with breathing irregularities, hyperventilation, and/or other neurological manifestations (dystonic movements, nystagmus). Interictal and ictal video-electroencephalography did not reveal epileptiform abnormalities. In all cases, brain magnetic resonance imaging showed a mass involving the cerebellar peduncle, the cerebellar hemisphere, or the floor of the fourth ventricle. The semiology of the paroxysmal attacks is probably due to the activation of cranial nerve nuclei through intralesional hypersynchronous discharges, as shown by the intraoperative recordings and functional brain imaging described in the literature. We point out the importance of identifying such seizures in order to make an early diagnosis of the underlying cerebral lesion.
Collapse
Affiliation(s)
- Nicola Specchio
- Division of Neurology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Yagyu K, Sueda K, Shiraishi H, Asahina N, Sakurai K, Kohsaka S, Sawamura Y, Saitoh S. Direct correlation between the facial nerve nucleus and hemifacial seizures associated with a gangliocytoma of the floor of the fourth ventricle: A case report. Epilepsia 2011; 52:e204-6. [DOI: 10.1111/j.1528-1167.2011.03299.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
15
|
Zamponi N, Passamonti C, Luzi M, Trignani R, Regnicolo L, Scarpelli M. Fourth ventricle hamartoma presenting with progressive myoclonus and hemifacial spasms: case report and review of literature. Childs Nerv Syst 2011; 27:1001-5. [PMID: 21560053 DOI: 10.1007/s00381-011-1427-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 03/03/2011] [Indexed: 10/18/2022]
Affiliation(s)
- Nelia Zamponi
- Pediatric Neurology Department, Ospedali Riuniti, Polytechnic University of the Marche Region, Via Corridoni, 11, 60122, Ancona, Italy.
| | | | | | | | | | | |
Collapse
|
16
|
Kubota KC, Itoh T, Yamada Y, Yamaguchi S, Ishida Y, Nakasu Y, Watanabe R, Ito I, Sawamura Y, Matsuno Y, Nagashima K. Melanocytic medulloblastoma with ganglioneurocytomatous differentiation: A case report. Neuropathology 2009; 29:72-7. [DOI: 10.1111/j.1440-1789.2008.00913.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
17
|
Minkin K, Tzekov C, Naydenov E, Ivanov I, Kulev O, Romansky K, Busarsky V. Cerebellar gangliocytoma presenting with hemifacial spasms: clinical report, literature review and possible mechanisms. Acta Neurochir (Wien) 2008; 150:719-24; discussion 724. [PMID: 18509586 DOI: 10.1007/s00701-008-1597-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 04/23/2008] [Indexed: 11/25/2022]
Abstract
Cerebellar lesions have classically been considered not to cause epilepsy. However, previous reports have attributed seizures, beginning as hemifacial spasms to lesions of the cerebellar peduncles. We report an example of paroxysmal facial contractions associated with a cerebellar gangliocytoma. The seizures began on the first day of life and consisted of paroxysmal contractions involving the left orbicularis oculi, often the left forehead and lower facial muscles, sometimes accompanied by nystagmoid eye movements to the right and by head deviation to the left. Video-EEG monitoring showed only artifacts from muscle contractions. Magnetic resonance imaging showed a mass arising from the left superior cerebellar peduncle and partially occupying the fourth ventricle. The lesion was removed subtotally and partial seizure control was achieved. The neuropathological findings were consistent with a gangliocytoma. The literature in the association of cerebellar lesions with hemifacial spasms is reviewed and its possible mechanisms discussed.
Collapse
Affiliation(s)
- K Minkin
- Department of Neurosurgery, Medical University of Sofia, University Hospital Saint Ivan Rilski, Sofia.
| | | | | | | | | | | | | |
Collapse
|