PMID: 11915612Mar 28, 2002Paper

Functional recuperation after resection of gliomas infiltrating primary somatosensory fields. Study of perioperative electric stimulation

Neuro-Chirurgie
H Duffau, L Capelle

Abstract

With the aim to achieve the most complete resection in cases of parietal low-grade glioma involving the primary somatosensory area (S I), the authors describe a series with resection of S I using an intraoperative brain mapping. The immediate and delayed postoperative functional results are analyzed. Six patients were operated on for a low-grade glioma involving S I, revealed by seizures with a normal clinical examination. All patients underwent awake surgery under local anesthesia, to allow realization of an intraoperative sensorimotor brain mapping using direct electrical stimulations. The primary motor area (M I) and S I were detected in all procedures. A part of infiltrated S I was removed in spite of a sensitive response of this area during stimulations (sensory face in 2 cases, upper limb area in 5 cases, and lower limb area in 2 cases). All patients presented an immediate postoperative sensory deficit, with recovery in the 6 cases within 3 months. Five resections were total and one subtotal. In our experience, the primary somatosensory area could be resected in case of tumoral infiltration, without inducing a permanent neurological deficit. This may be due to brain plasticity mechanisms, with recruitment of loco-regional...Continue Reading

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