Background: Low-grade epilepsy-associated neuroepithelial tumors (LEATs) are a frequent etiology in pediatric patients with epilepsy undergoing surgery. Objective: To identify differences in clinical and post-surgical follow-up between patients with focal meningeal involvement (MI) and those without MI within our cohort of pediatric patients with LEATs. Methods: We retrospectively reviewed all pediatric patients (<18 y) who underwent epilepsy surgery between 2011 and 2017 at our hospital. Cohort inclusion required histological diagnosis of LEATs and post-surgical follow-up of ≥2 y. We subsequently stratified patients according to presence of neuroradiological MI. Results: We identified 37 patients: five with MI and 32 without. Half of patients (19) were drug sensitive at surgery; similar between groups. The group with MI differed mainly for age of epilepsy-onset (0.6 vs. 7.0 y) but not for epilepsy duration (0.9 vs. 1.5 y). Post-surgery radiological follow-up (median 4.0 y; IQR 2.8–5.0 y) did not indicate disease progression. Seizure outcome was excellent in both groups, with 34 patients overall being both drug- and seizure-free. Conclusions: Our study identified a new subgroup of LEATs with focal MI and excellent post-surgical outcome. Moreover, this highlights the effectiveness of early surgery in pediatric LEATs.

中文翻译：

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低度癫痫相关肿瘤和局灶性脑膜受累引起的早期发作性癫痫

背景：低度癫痫相关的神经上皮肿瘤（LEATs）是小儿癫痫手术患者的常见病因。目的：确定在我们的LEATs小儿患者队列中，有局灶性脑膜受累（MI）的患者和无MI的患者在临床和术后随访中的差异。方法：我们回顾性分析了2011年至2017年间在我院进行了癫痫手术的所有小儿患者（<18岁）。队列纳入要求对LEATs进行组织学诊断，且术后随访≥2年。我们随后根据神经放射学MI的存在对患者进行分层。结果：我们确定了37例患者：5例有MI，32例无MI。一半的患者（19）在手术时对药物敏感；组之间相似。MI组主要在癫痫发作年龄方面有所不同（0.6 vs. 7.0 y），但在癫痫持续时间方面无差异（0.9 vs. 1.5 y）。手术后放射学随访（中位4.0 y； IQR 2.8-5.0 y）未显示疾病进展。两组的癫痫发作结局均极佳，共有34例患者既无毒品也无癫痫发作。结论：我们的研究确定了具有局灶性心肌梗死和良好的术后预后的新的LEAT亚组。此外，这突显了儿童LEATs早期手术的有效性。