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Sturge–Weber syndrome

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Abstract

Introduction

Sturge–Weber syndrome (SWS) is a rare neurocutaneous syndrome the main clinical features of which are facial, mostly unilateral nevi, leptomeningeal angiomatosis, and congenital glaucoma. The interest of this syndrome for pediatric neurosurgeons is mainly related to the association of SWS with epilepsy in 75–90% of the cases. Seizures are resistant to medical treatment in almost 60% of these patients that consequently should be evaluated for epilepsy surgery.

Indications to surgical treatment

Children with SWS and drug-resistant epilepsy are optimal candidates for disconnective or resective surgical procedures in terms of both seizure control and intellectual outcomes. Controversies, however, still exist between the advantages of early “prophylactic” operation vs later surgical interventions. Though better results in terms of seizures control and psychomotor development were reported in a limited series of children operated on early in life, the insufficient number of subjects who underwent the surgical treatment does not allow definite conclusions yet.

Neurosurgical techniques

Visually guided lobectomy with complete excision of the angiomatous cortex should be considered as the primary surgical procedure in patients with focal lesions. Hemispherectomy is the treatment of choice in children with extensive hemispheric lesions.

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References

  1. Alexander GL (1972) Sturge–Weber disease. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology. The phakomatoses, vol. 14. Elsevier, New York, pp 223–240

    Google Scholar 

  2. Alexander G, Norman RM (1960) The Sturge–Weber Syndrome. J Wright and Sons, Bristol

    Google Scholar 

  3. Arzimanoglou A, Aicardi J (1992) The epilepsy of Sturge–Weber syndrome: clinical features and treatment in 23 patients. Acta Neurol Scand 140:S18–S22

    Google Scholar 

  4. Arzimanoglou A, Andermann F, Aicardi J, Sainte-Rose C, Beaulieu MA, Villemure JG, Olivier A, Rasmussen Th (2000) Sturge–Weber syndrome. Indications and results of surgery in 20 patients. Neurology 55:1472–1479

    PubMed  CAS  Google Scholar 

  5. Bergstrand H, Olivecrona H, Tonnis W (1936) Gefassmissbildungen and gefassgeschwulte des gehrins. Thieme, Leipzig, p 181

    Google Scholar 

  6. Chao DHC (1959) Congenital neurocutaneous syndromes of childhood. III. Sturge–Weber disease. J Pediatr 55:635–648

    Article  PubMed  CAS  Google Scholar 

  7. Chapieski L, Friedman A, Lachar D (2000) Psychological functioning in children and adolescents with Sturge–Weber syndrome. J Child Neurol 3:181

    Google Scholar 

  8. Chugani HT (1994) The role of PET in childhood epilepsy. J Child Neurol 9(1):S82–S88

    PubMed  Google Scholar 

  9. Comi A (2003) Pathophysiology of Sturge–Weber syndrome. J Child Neurol 18:509–516

    Article  PubMed  Google Scholar 

  10. Comi A, Hunt P, Vawter MP, Pardo CA, Becker KG, Pevsner J (2003) Increased fibronectin expression in Sturge–Weber syndrome fibroblasts and brain tissue. Pediatr Res 53(5):762–769

    Article  PubMed  CAS  Google Scholar 

  11. Cunha e Sa M, Barroso CP, Caldas MC, Edvinsson L, Gulbenkian S (1997) Innervation pattern of malformative vessels in Sturge–Weber disease: an histochemical. Immunohistochemical and ultrastructural study. Neurosurgery 41(4):872–877

    Article  PubMed  Google Scholar 

  12. Cushing H (1906) Cases of spontaneous intracranial hemorrhage associated with trigeminal nevi. JAMA 47:178–183

    Google Scholar 

  13. Dimitri V (1923) Tumor cerebral congénito (angioma cavernosum) Rev Asoc Med Argent 36:1029–1037

    Google Scholar 

  14. Di Rocco C (1992) Sturge–Weber disease. In : Raimondi AJ, Choux M, Di Rocco C (eds) Cerebrovascular diseases in children, Springer, Berlin Heidelberg New York, pp 168–187

    Google Scholar 

  15. Di Trapani G, Di Rocco C, Abbamonti AL, Caldarelli M (1982) Light microscopy and ultrastructural studies of Sturge–Weber disease. Childs Brain 9:23–36

    Article  PubMed  Google Scholar 

  16. Duncan DB, Herholz K, Pietrzyk U, Heiss WD (1995) Regional cerebral blood flow and metabolism in Sturge–Weber disease. Clin Nucl Med 20(6):522–523

    Article  PubMed  CAS  Google Scholar 

  17. Elster AD, Chen MY (1990) MR imaging of Sturge–Weber syndrome: role of Gadopentate dimeglumine and gradient-echo techniques. AJNR Am J Neuroradiol 11:685–689

    PubMed  CAS  Google Scholar 

  18. Falconer MA, Rushworth RG (1960) Treatment of encephalotrigeminal angiomatosis (Sturge–Weber disease) by hemispherectomy. Arch Dis Child 35:433–447

    PubMed  CAS  Google Scholar 

  19. Faller L, Lemmer J (2003) Encephalotrigeminal angiomatosis. SADJ 58(9):370–373

    Google Scholar 

  20. Goscinski I, Kunicki A (1972) On surgical treatment of Sturge–Weber syndrome. Acta Med Pol 13:229–236

    PubMed  CAS  Google Scholar 

  21. Griffiths PD (1996) Sturge–Weber syndrome revisited: the role of neuroradiology. Neuropediatrics 27:284–294

    Article  PubMed  CAS  Google Scholar 

  22. Griffiths PD, Boodram MB, Blaser S, Armstrong D, Gilday DL, Harwood-Nash D (1997) 99mTechnetium HMPAO imaging in children with the Sturge–Weber syndrome: a study of nine cases with CT and MRI correlation. Neuroradiology 39:219–224

    Article  PubMed  CAS  Google Scholar 

  23. Gururaj AK, Sztriha L, Johansen J, Nork M (2000) Sturge–Weber syndrome without facial nevus: a case report and review of the literature. Acta Pediatr 89:740–743

    Article  CAS  Google Scholar 

  24. Hoffman HJ, Hendrick EB, Dennis M (1979) Hemispherectomy for Sturge–Weber syndrome. Childs Brain 5:233–248

    Article  PubMed  CAS  Google Scholar 

  25. Horita H, Nozaki H, Hamano S, Aihara T (1990) SPECT of the brain in Sturge–Weber syndrome using N-isopropyl-p[123-I]. No To Hattatsu 22:341–348

    PubMed  CAS  Google Scholar 

  26. Ichinose T, Tsuyuguchi N, Morino M, Sunada I, Ohata K, Takami T, Shimonishi Y, Kwabe J, Shiomi S, Hara M (2003) Discrepancy between 18F FDG and 11C-methionine positron emission tomography findings in Sturge–Weber syndrome—case report. Neurol Med Chir 43(9):461–464

    Article  Google Scholar 

  27. Ito M, Sato K, Ohnuki A, Uto A (1990) Sturge–Weber disease: operative indications and surgical results. Brain Dev 12(5):473–477

    PubMed  CAS  Google Scholar 

  28. Juhasz C, Chugani DC, Muzik O et al (2000) Is epileptogenic cortex truly hypometabolic on interictal positron emission tomography? Ann Neurol 48:89–96

    Article  Google Scholar 

  29. Kalischer S (1897) Demonstration des Gehirns eines kindes mit teleangiektasie der linksseitigen gesichts-kopfhaut und hirnoberflache. Berl Klin Wochenschr 34:1059–1067

    Google Scholar 

  30. Kossoff EH, Buck C, Freeman JM (2002) Outcomes of 32 hemispherectomies for Sturge–Weber syndrome worldwide. Neurology 59(1):1735–1738

    PubMed  Google Scholar 

  31. Krabbe KH (1934) Facial and meningeal angiomatosis associated with calcification of the brain cortex: a clinical and anatomopathological contribution. A M A Arch Neurol Psych 32:737–755

    Google Scholar 

  32. Kuhl DE, Bevilacqua JE, Mishkin MM, Sanders PP (1972) The brain scan in Sturge–Weber syndrome. Radiology 103:621–625

    PubMed  CAS  Google Scholar 

  33. Lee JS, Asano E, Muzik O Chugani DC, Juhasz C, Pfund Z, Philip S, Behen M, Chugani HT (2001) Sturge–Weber syndrome: correlation between clinical course and FDG PET findings. Neurology 57(2):189–195

    PubMed  CAS  Google Scholar 

  34. Lin DM, Barker PB, Kraut MA, Comi A (2003) Early characteristics of Sturge–Weber syndrome, shown by perfusion MR imaging and proton MR spectroscopic imaging. AJNR Am J Neuroradiol 24:1912–1915

    PubMed  Google Scholar 

  35. Lund M (1949) On epilepsy in Sturge–Weber disease. Acta Psychiatr Neurol 24:569–586

    Article  PubMed  CAS  Google Scholar 

  36. Maria BL (2000) Current management in child neurology. BC Decker, London

    Google Scholar 

  37. Maria BL, Neufeld JA, Rosainz LC et al (1998) Central nervous system structure and function in Sturge–Weber syndrome: evidence of neurologic and radiologic progression. J Child Neurol 13:606–618

    PubMed  CAS  Google Scholar 

  38. Moore GJ, Slovis TL, Chugani HT (1998) Proton magnetic resonance spectroscopy in children with Sturge–Weber syndrome. J Child Neurol 13:332–335

    PubMed  CAS  Google Scholar 

  39. Muller RA, Chugani HT, Muzik O, Rothermel RD, Chakraborty PK (1997) Language and motor function activate calcified hemisphere in patients with Sturge–Weber syndrome: a positron emission tomography study. J Child Neurol 12(7):431–437

    PubMed  CAS  Google Scholar 

  40. Namer IJ, Battaglia F, Hirsch E, Constantinesco A, Marescaux C (2005) Subtraction Ictal SPECT co-registered to MRI (SISCOM) in Sturge–Weber syndrome Clin Nucl Med 30(1):39–40

    Article  PubMed  CAS  Google Scholar 

  41. Ongumekan AO, Hwang PA, Hoffman HJ (1989) Sturge–Weber–Dimitri disease. Role of hemispherectomy in prognosis. Can J Neurol Sci 16:78–80

    Google Scholar 

  42. Pagni CA, Wildi E (1977) Pathogenetic hypothesis of intracortical calcifications in Sturge–Weber disease. Case report following lobectomy. Mod Probl Paediatr 18:250–257

    Google Scholar 

  43. Penfield W (1952) Ablation of abnormal cortex in cerebral palsy. J Neurol Neurosurg Psychiatry 15:73–78

    PubMed  CAS  Google Scholar 

  44. Peterman AF, Hayles AB, Dockerty MB, Love JC (1958) Encephalotrigeminal angiomatosis (Sturge–Weber disease) Clinical study of thirty-five cases. JAMA 167:2169–2176

    CAS  Google Scholar 

  45. Pinton F, Chiron C, Enjolras O, Motte J, Syrota A, Dulac O (1997) Early single photon emission computed tomography in Sturge–Weber syndrome. J Neurol Neurosurg Psychiatry 63:616–621

    PubMed  CAS  Google Scholar 

  46. Rappaport ZH (1988) Corpus callosum section in the treatment of intractable seizures in the Sturge–Weber syndrome. Childs Nerv Syst 4:231–232

    Article  PubMed  CAS  Google Scholar 

  47. Rasmussen Th, Mathieson G, Le Blanc F (1972) Surgical therapy of typical and a forme fruste variety of the Sturge–Weber syndrome. Schweiz Arch Neurol Psychiatr 111: 393–409

    CAS  Google Scholar 

  48. Reid DE, Maria BL, Drane WE, Quisling RG, Hoang KB (1997) Central nervous system perfusion and metabolism abnormalities in Sturge–Weber syndrome. J Child Neurol 12:218–222

    PubMed  CAS  Google Scholar 

  49. Roach ES (1992) Neurocutaneous syndromes. Pediatr Clin North Am 39:591–620

    PubMed  CAS  Google Scholar 

  50. Roach ES, Bodensteiner J (1999) Neurologic manifestations of Sturge–Weber syndrome. In: Bodensteiner JB, Roach ES (eds) Sturge–Weber syndrome. The Sturge–Weber Foundation, Mount Freedom, NJ, pp 27–38

    Google Scholar 

  51. Roach ES, Riela AR, Chugani HT et al (1994) Sturge–Weber syndrome. Recommendations for surgery. J Child Neurol 9:190–192

    PubMed  CAS  Google Scholar 

  52. Schrimer R (1860) Ein fall von telangiektasie. Albrecht von Graefes. Arch Ophtalmol 7:119–121

    Google Scholar 

  53. Sturge WA (1879) A case of partial epilepsy apparently due to a lesion of the vasomotor centers of the brain. Trans Clin Soc Lond 12:162–167

    Google Scholar 

  54. Sujansky E, Conradi S (1995) Outcome of Sturge–Weber syndrome in 52 adults. Am J Med Genet 57:35–45

    Article  PubMed  CAS  Google Scholar 

  55. Sujansky E, Conradi S (1995) Sturge–Weber syndrome. Age of onset of seizures and glaucoma and the prognosis for affected children. J Child Neurol 10:49–58

    PubMed  CAS  Google Scholar 

  56. Tallman B, Tan OT, Morelli JG et al (1991) Location of port-wine stains and the likelihood of ophthalmic and/or central nervous system complications. Pediatrics 87:323–327

    PubMed  CAS  Google Scholar 

  57. Thomas-Sohl KA, Vaslow DF, Maria BL (2004) Sturge–Weber Syndrome: a review. Pediatr Neurol 30(5):303–310

    Article  PubMed  Google Scholar 

  58. Tuxhorn IEB, Pannek HW (2002) Epilepsy surgery in bilateral Sturge–Weber syndrome. Pediatr Neurol 26(5):394–397

    Article  PubMed  Google Scholar 

  59. Venes JL, Linder S (1989) Sturge–Weber–Dimitri syndrome. Encephalotrigeminal angiomatosis. In: Edwards MSB, Hoffman HJ (eds) Cerebral vascular disease in children and adolescents. Williams & Wilkins, Baltimore, pp 337–341

    Google Scholar 

  60. Ville D, Enjolras O, Chiron C, Dulac O (2002) Prophylactic antiepileptic treatment in Sturge–Weber disease. Seizure 11(3):145–150

    Article  PubMed  CAS  Google Scholar 

  61. Weber FP (1922) Right-sided hemi-hypertrophy resulting from right sided congenital spastic hemiplegia. J Neurol Psychopathol 3:134–139

    Article  Google Scholar 

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Correspondence to G. Tamburrini.

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Di Rocco, C., Tamburrini, G. Sturge–Weber syndrome. Childs Nerv Syst 22, 909–921 (2006). https://doi.org/10.1007/s00381-006-0143-2

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