Clinical features and surgical outcome of patients with indolent brain tumors and epilepsy

Abstract

INTRODUCTION: In this study the authors review the outcomes of 22 patients with medically refractory epilepsy and slow growth brain tumors. OBJECTIVES: Evaluate the clinical, electrophysiological, operative, and histopathological features. PATIENTS AND RESULTS: The majority of the tumors were located in the temporal lobe (n = 20) and involved the cortical gray matter. The most frequent tumors were gangliogliomas (n = 9), astrocytomas grade I and II (n = 6), dysembryoplastic neuroepithelial tumors (n = 5) and ganglioneuroma (n = 2). The biological behavior of the tumors was strikingly indolent, as indicated by a long preoperative history of chronic seizures (mean, 14 years). Mean follow-up time after resection was 27 months, and according to Engel’s classification, 85% were seizure-free, 10% showed a reduction of seizure frequency of at least 90%, and 5% had reduction in seizure frequency at least 75%. CONCLUSION: The data indicate that neoplasms associated with pharmacoresistent epilepsy constitute a distinct clinicopathological group of tumors that arise in young patients, involve the cortex, and exhibit indolent biological behavior for many years. Complete surgical removal of these tumors, including the epileptogenic area, can achieve excellent seizure control.

Tumor-Related Epilepsy and Post-Surgical Outcomes: Tertiary Hospital Experience in Saudi Arabia

“…Two of the best predictors of freedom from post-operative seizures include a duration of less than one year since the onset of epilepsy and gross total surgical resection [15,16]. Tumor histopathology plays a significant role in predicting freedom from seizures after epilepsy surgery; however, there is no consensus among researchers regarding this issue [17,18]. This study retrospectively investigated different types of tumor-related epilepsy and their outcomes in the first year after epilepsy surgery.…”

“…Despite the abundance of knowledge regarding surgical management of resistant forms of epilepsy, including those associated with brain tumors, especially of the low-grade type, prospective studies regarding the medical treatment of epilepsy in this type of patient are scarce [11]. Reportedly, resection of the epileptogenic zone due to the development of brain tumors lead to freedom from or significant control of seizures in 70-90% of patients [12,13]. Furthermore,…”

Tumour - Related Epilepsy and Post-Surgical Outcome: Tertiary Hospital Experience in Saudi Arabia

“…[19] Reportedly, resection of the epileptogenic zone may lead to freedom from or signi cant control of seizures in 70-90% of patients. [20,21] Furthermore, tumor type, seizure severity, early surgical intervention, frequency during the preoperative stage, histopathology of the tumors, and the extension of surgical resection to include peritumoral tissues are, reportedly, the factors that increase the likelihood of freedom from seizures postoperatively. [22] Two of the best predictors of freedom from seizures post-operation include a duration of less than 1 year since the onset of epilepsy and gross total surgical resection.…”

“…[23,24] Some recent studies have suggested that tumor histopathology plays a signi cant role in predicting freedom from seizures post epilepsy surgery; however, there is no consensus among researchers regarding this issue. [25,26] In this study we retrospectively looked for different brain tumors and their one-year post epilepsy surgery outcome.…”