Experience in treating children with ocular dyskinesia and hemifacial spasm secondary to pontine tumours adjacent to the fourth ventricle and systematic review

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..

OBJECTIVE: To investigate the treatment plan and prognosis of children with ocular dyskinesia and hemifacial spasm secondary to pontine tumours adjacent to the fourth ventricle.

METHODS: In this retrospective study, the clinical information of 10 consecutively collected children with ocular dyskinesia and hemifacial spasm secondary to pontine tumours adjacent to the fourth ventricle was analyzed. All 10 children underwent pontine tumour resection through a trans-cerebellomedullary fissure approach; 4 children underwent preoperative diffusion tensor imaging scans to determine the relationship between the tumour and facial nerve nucleus, and the other 6 children underwent intraoperative deep electroencephalography (EEG) tumour monitoring, in which the tumour electrical discharge activity of the tumour was recorded. A voxel distribution map was established to describe the distribution of the tumour location, and patient prognosis was evaluated through clinical and imaging follow-up.

RESULTS: All 10 children achieved total tumour resection; 9 tumours were pathologically suggested to be ganglioglioma (WHO grade I), and 1 was a hamartoma. The symptoms of the original ocular dyskinesia and hemifacial spasm disappeared immediately after the operation. The children were followed up for 4-75 months, and none of the symptoms recurred; four cases with preoperative diffusion tensor imaging showed that the tumour was close to the facial nerve. Four in six intraoperative electrophysiological monitoring showed that the tumour had electrical discharge behaviour, and the tumour distribution map indicates a high density of tumour presence in the facial nerve nucleus and the nucleus of the abducens nerve.

CONCLUSIONS: In paediatric patients, the facial symptoms are related to the location and abnormal electrical discharge of the tumour. There is no significant correlation between ocular dyskinesia and the location of the tumour. Conventional antiepileptic therapy for this disease is ineffective, and early surgical intervention for total tumour resection can achieve a clinical curative effect.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:40

Enthalten in:

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery - 40(2024), 5 vom: 01. Apr., Seite 1349-1360

Sprache:

Englisch

Beteiligte Personen:

Cai, Yingjie [VerfasserIn]
Yang, Wei [VerfasserIn]
Peng, Xiaojiao [VerfasserIn]
Yuan, Liu [VerfasserIn]
Ge, Ming [VerfasserIn]

Links:

Volltext

Themen:

Children
Fourth ventricle
Hemifacial spasm
Journal Article
Ocular dyskinesia
Pontine tumour
Systematic Review

Anmerkungen:

Date Completed 19.04.2024

Date Revised 19.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00381-024-06280-4

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367175835