T2 weighted magnetic resonance image (MRI) scan of 28 year old woman with complex partial seizures but no focal neurological deficit. T2 weighted magnetic.

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Presentation transcript:

T2 weighted magnetic resonance image (MRI) scan of 28 year old woman with complex partial seizures but no focal neurological deficit. T2 weighted magnetic resonance image (MRI) scan of 28 year old woman with complex partial seizures but no focal neurological deficit. There is a hyper intense signal abnormality in the left temporal lobe and insular. The lesion did not contrast enhance and radiologically fits a classical appearance of a temporal–opercular–insular low grade glioma. This type of tumour more than any other characterises the dilemma in management of such patients. This woman’s seizure disorder was controlled to some degree with anticonvulsants and she had a subtotal excision, which led to a diagnosis of oligodendroglioma grade II and complete cessation of her seizure disorder. Attempted complete excision of such lesions, even if performed using awake craniotomy techniques, can be followed by major neurological disabilities. I R Whittle J Neurol Neurosurg Psychiatry 2004;75:ii31-ii36 ©2004 by BMJ Publishing Group Ltd