{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T05:24:56Z","timestamp":1792214696120,"version":"4.4.0"},"reference-count":90,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Beyond its oncological benefit, surgery could improve seizure control in paralimbic frontotemporoinsular or temporoinsular WHO Grade II gliomas generating intractable seizures. However, no studies have examined the impact of hippocampal resection on chronic epilepsy when the hippocampus is not invaded by Grade II gliomas. Here, the authors compared the epileptological outcomes and return to work in 2 groups of patients who underwent surgery with or without hippocampectomy for paralimbic Grade II gliomas eliciting intractable epilepsy despite no tumoral involvement of the hippocampus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Surgery was performed in 15 consecutive patients who were unable to work (median Karnofsky Performance Scale [KPS] Score 70) because of refractory epilepsy due to paralimbic Grade II gliomas that were not invading the hippocampus. In Group A (8 patients), the hippocampus was preserved. In Group B (7 patients), glioma removal was associated with hippocampectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No patient died or suffered a permanent deficit after surgery. Postoperatively, in Group A, no patients were seizure free (4 patients were in Engel Class II and 4 were in Class III). In Group B, all 7 patients were seizure free (Class I) (p = 0.02). Only 62.5% of patients returned to work in Group A, whereas all patients are working full time in Group B. The postsurgical median KPS score was 85 in Group A, that is, not significantly improved in comparison with the preoperative score, while the postsurgical median KPS was 95 in Group B, that is, significantly improved in comparison with the preoperative score (p = 0.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The authors' data support, for the first time, the significant impact of hippocampectomy in patients with intractable epilepsy generated by a paralimbic Grade II glioma, even if it does not invade the hippocampus. Hippocampal resection allowed seizure control in all patients, with an improvement in KPS scores, since all patients resumed their social and professional activities. Thus, the authors suggest performing a resection of the nontumoral hippocampus in addition to resection of the tumor in patients with refractory epilepsy due to paralimbic Grade II gliomas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2012.1.jns112120","type":"journal-article","created":{"date-parts":[[2012,3,9]],"date-time":"2012-03-09T10:04:42Z","timestamp":1331287482000},"page":"1226-1234","source":"Crossref","is-referenced-by-count":67,"title":["Intractable epilepsy in paralimbic World Health Organization Grade II gliomas: should the hippocampus be resected when not invaded by the tumor?"],"prefix":"10.3171","volume":"116","author":[{"given":"Fadi","family":"Ghareeb","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Riyadh Military Hospital, Riyadh, Saudi Arabia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugues","family":"Duffau","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center; and"},{"name":"Team \u201cPlasticity of Central Nervous System, Stem Cells and Glial Tumors,\u201d INSERM U1051, Institute for Neurosciences of Montpellier, Montpellier University Medical Center, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns112120","series-title":"Neuroscience","first-page":"59","article-title":"Vesicular glutamate transporter 1 immunostaining in the normal and epileptic human cerebral cortex","volume":"134","author":"Alonso-Nanclares","year":"2005"},{"key":"b2-jns112120","series-title":"Proc Natl Acad Sci U S A","first-page":"15551","article-title":"Emergence of complex dynamics in a simple model of signaling network","volume":"101","author":"Amoral","year":"2004"},{"key":"b3-jns112120","series-title":"Acta Neuropathol","first-page":"449","article-title":"Expression of connexin 43 and connexin 32 gapjunction proteins in epilepsy-associated brain tumors and in the perilesional epileptic cortex","volume":"101","author":"Aronica","year":"2001"},{"key":"b4-jns112120","series-title":"Neuropathol Appl Neurobiol","first-page":"223","article-title":"Ionotropic and metabotropic glutamate receptor protein expression in glioneuronal tumours from patients with intractable epilepsy","volume":"27","author":"Aronica","year":"2001"},{"key":"b5-jns112120","series-title":"Brain Res Brain Res Rev","first-page":"229","article-title":"Circuitry and functional aspects of the insular lobe in primates including humans","volume":"22","author":"Augustine","year":"1996"},{"key":"b6-jns112120","series-title":"Ann Neurol","first-page":"128","article-title":"How do brain tumors alter functional connectivity? 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