Ganglioglioma surgery associated with postoperative status epilepticus : a case report

Background: Gangliogliomas are brain tumors associated with drug-resistant focal epilepsy. In most cases, seizures improve after surgical treatment. It is still not concluded to what extent the lesion itself or the perilesional area contributes to the epileptogenicity. Case presentation: In the case presented in this report, the patient, a 24-year-old Caucasian male, developed a refractory status epilepticus after a surgical attempt to remove a cerebral ganglioglioma. The postoperative magnetic resonance imaging revealed that the lesion was intact, and that inadvertently only the perilesional area and adjacent cortex had been resected. The patient underwent a new surgical procedure where the ganglioglioma was removed, and the status epilepticus cessated. Conclusions: This clinical case suggests that the lesion itself plays an important role in seizure generation and propagation, and notably, that the surrounding cortex by an inhibitory action can act as a gate to seizure spread