Temporal lobe gangliogliomas in children.

The ganglioglioma, a mixed tumor with neuronal and glial elements, occurs occasionally in children and young adults. Its incidence, clinical presentation, radiological features, and natural history have not been clearly defined. A review of 111 primary brain tumors treated at our institution shows that 9.0% were gangliogliomas. The temporal lobe was the most common site involved. All patients presented with seizures but were neurologically intact. The CT scan showed a partially calcified mass, frequently isodense or nearly so, with minimal enhancement. Complete removal produced dramatic improvement in seizure control. Radiotherapy and/or chemotherapy are reserved for tumors showing malignant changes in the astrocytic component. Patients with chronic epilepsy, or whose seizures escape control despite anticonvulsants, should be examined with this tumor in mind. Following removal of these low-grade temporal lobe tumors, fewer seizures are seen, and the long-term prognosis is very good.