[Neuropsychology of temporal partial epilepsy: a comparison of drug resistant and pharmacologically controlled patients]. / Neuropsicología de la epilepsia parcial temporal: comparación entre pacientes farmacorresistentes y pacientes controlados farmacológicamente.

INTRODUCTION: Various factors may contribute to cognitive deterioration in temporal lobe epilepsy, and there is controversy as to which has the greatest effect. PATIENTS AND METHODS: In this study, we establish a comparison between patients with temporal lobe epilepsy controlled by drugs and drug-resistant patients, with the object of discovering the effect of different factors in causing cognitive damage. RESULTS: The persons whose disorder was controlled by pharmacological means had better results in memory and intelligence tests than those with drug-resistance. The latter had alterations of declarative memory for verbal material (left) and for visio-spatial material (right) in delayed free recall tests. Also, the greater proportion of symptomatic epilepsies in the drug-resistant group affected their greater cognitive deterioration. CONCLUSIONS: Our results show that having long-standing epilepsy with great frequency of seizures and symptomatic epilepsy is correlated with cognitive alterations in memory function in temporal lobe epilepsy. Most deterioration is seen in patients with long-standing drug resistant symptomatic left mesial temporal epilepsy.

Craniopharyngiomas: a critical approach to treatment.

The authors have conducted a retrospective statistical study in a series of 45 patients with craniopharyngiomas in order to assess the value of different therapeutic approaches. All the patients included in the study were placed in three groups according to their method of treatment: 1) total excision; 2) subtotal excision; and 3) surgery followed by a course of radiotherapy (RT). Symptomatic recurrence was used to define failure of treatment. Of the patients subjected to total excision, 30% experienced recurrence after a mean time of 2 years. Tumors recurred in 71% of those treated by subtotal excision, with a mean time of 2.6 years. Of patients receiving RT in addition to surgery, only 6% had recurrence, after a mean time of 1 year. The authors conclude that the elective treatment for craniopharyngiomas is controlled subtotal surgery plus RT. Total excision should be attempted only if there is a negligible danger of mortality.

Intratumoral hemorrhage in posterior fossa tumors after ventricular drainage. Report of two cases.

Severe intratumoral hemorrhage in posterior fossa tumors is reported in two children, one with a Grade I astrocytoma, and the other with a medulloblastoma. Fatal bleeding occurred a few hours after insertion of ventricular drainage for preoperative management of obstructive hydrocephalus.