Surgical Treatment Of Supratentorial Epidermoid Cysts With Epilepsy

Objective:To study the clinical characteristics and surgical treatment of supratentorial epidermoid cysts.Methods:We collected the clinical data of 10 cases of histopathological confirmed supratentorial epidermoid cysts. Demographic, clinical, imaging and electroencephalographic data were assessed. All 10 patients received surgical treatment. Postoperative complications, epilepsy and neurological recovery were recorded in 3.3～34.6 months’ follow-up. The clinical characteristics and results of the treatment were compared between the supratentorial epidermoid cysts with and without epilepsy.Results:Of the 10 cases analyzed supratentorial epidermoid cysts were 4 males and 6 females, mean of age 42.75y (range 17-55y). These supratentorial epidermoid cysts were located in saddle area (3 cases), temporal lobe (2 cases), parietal lobe (1 case), frontal lobe (3 cases) and multiple lobes (1 case). Epilepsy was confirmed in 4 (40%) case. Max diameter of cysts with epilepsy was 41.0±9.9 mm, tented to larger than that of cysts without epilepsy 27.8±10.9 mm (p=0.089, t-test). Of 4 cases of epidermoid cysts with epilepsy,3 (75%) cases were radiologically atypical,3 (75%)cases of cysts adhered to brain tissue,1 case with focal cortical dysplasia and 1 case with postoperative epilepsy. Total removal rate was 60%.2 cases of Mollaret’s meningitis,1 case of hematoma were confirmed after operation.2 (50%)cases of epidermoid cysts with epilepsy had postoperative complications during the follow-up.Conclusion:The structural relationship between epidermoid cysts and surrounding tissue should be well understood before the operation through the VEEG and ECoG When total epidermoid cyst is resected, epileptic lesion should be advocated to cope with at the same timed.