Hemifacial Seizure of Cerebellar Ganglioglioma Origin: Seizure Control by Tumor Resection

• Published in: Epilepsia (Copenhagen) Vol. 42; no. 9; pp. 1204 - 1207
• Main Authors: Chae, Jong Hee, Kim, Seung‐Ki, Wang, Kyu‐Chang, Kim, Ki Joong, Hwang, Yong‐Seung, Cho, Byung‐Kyu
• Format: Journal Article
• Language: English
• Published: Boston, MA, USA Blackwell Science Inc 01.09.2001; Blackwell
• Subjects: Biological and medical sciences; Cerebellar ganglioglioma; Cerebellar Neoplasms - complications; Cerebellar Neoplasms - diagnosis; Cerebellar Neoplasms - surgery; Cerebellum - surgery; Epilepsy - diagnosis; Epilepsy - etiology; Epilepsy - surgery; Epileptic seizure; Ganglioglioma - complications; Ganglioglioma - diagnosis; Ganglioglioma - surgery; Hemifacial Spasm - diagnosis; Hemifacial Spasm - etiology; Hemifacial Spasm - surgery; Humans; Infancy; Infant; Magnetic Resonance Imaging; Male; Medical sciences; Neurology; Neurosurgery; Neurosurgical Procedures - methods; Reoperation; Skull, brain, vascular surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Tropical medicine; Tumors of the nervous system. Phacomatoses; Human; Cerebellum; Hemifacial spasm; Nervous system diseases; Male; Infant; Surgical resection; Cerebral disorder; Case study; Ganglioglioma; Treatment; Glioma; Convulsion; Surgery; Central nervous system disease; Tumor; Complication; Neurological disorder
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1046/j.1528-1157.2001.43398.x

The cerebellum is known to have an inhibitory effect on seizures. Nevertheless, cerebellar dysplastic lesions can be epileptogenic. A 4‐month‐old infant had paroxysmal facial contractions; tachypnea and nystagmoid eyeball and tremulous movements were occasionally combined. These evolved to stereotypic clinical patterns and frequencies, which increased despite administration of antiepileptic drugs (AEDs). Magnetic resonance imaging (MRI) demonstrated a mass arising from the superior cerebellar peduncle, although video‐scalp EEG monitoring revealed no abnormal findings. Positron emission tomography with [18F]fluorodeoxyglucose revealed focal hypermetabolism in the same area identified by MRI. A depth electrode implanted in the mass revealed focal spike‐and‐wave discharges. The lesion was partly removed; pathologic diagnosis was ganglioglioma. Because of incomplete seizure control and residual tumor visible on MRI, a second operation was performed. After complete excision of the tumor, the patient became seizure free without AEDs. This case confirms the presence of seizure originating from the cerebellum and emphasizes the need for the complete removal of an epileptogenic lesion.