Brain Tumor and Seizures: Incidence, Pathophysiology, Diagnosis and Treatment

James, Elysia; Varelas, Panayiotis N.

doi:10.5772/21100

Cited by 3 publications

(3 citation statements)

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“…3 This may not be surprising when considering that peritumoral cortical irritation and the disruption of inhibitory cellular networks are thought to contribute to elevated seizure risk in glioma patients. 19,45,46 Incomplete seizure risk elimination would be expected to accompany the incomplete removal of the offending neoplasm.…”

Section: Seizures and Health Care Quality Accountabilitymentioning

confidence: 99%

Perioperative seizure in patients with glioma is associated with longer hospitalization, higher readmission, and decreased overall survival

Dewan¹,

White-Dzuro²,

Brinson³

et al. 2016

JNS

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OBJECTIVE Seizures are among the most common perioperative complications in patients undergoing craniotomy for brain tumor resection and have been associated with increased disease progression and decreased survival. Little evidence exists regarding the relationship between postoperative seizures and hospital quality measures, including length of stay (LOS), disposition, and readmission. The authors sought to address these questions by analyzing a glioma population over 15 years. METHODS A retrospective cohort study was used to evaluate the outcomes of patients who experienced a postoperative seizure. Patients with glioma who underwent craniotomy for resection between 1998 and 2013 were enrolled in the institutional tumor registry. Basic data, including demographics and comorbidities, were recorded in addition to hospitalization details and complications. Seizures were diagnosed by clinical examination, observation, and electroencephalography. The Student t-test and chi-square test were used to analyze differences in the means between continuous and categorical variables, respectively. Multivariate logistic and linear regression was used to compare multiple clinical variables against hospital quality metrics and survival figures, respectively. RESULTS In total, 342 patients with glioma underwent craniotomy for first-time resection. The mean age was 51.0 ± 17.3 years, 192 (56.1%) patients were male, and the median survival time for all grades was 15.4 months (range 6.2-24.0 months). High-grade glioma (Grade III or IV) was seen in 71.9% of patients. Perioperative antiepileptic drugs were administered to 88% of patients. Eighteen (5.3%) patients experienced a seizure within 14 days postoperatively, and 9 (50%) of these patients experienced first-time seizures. The mean time to the first postoperative seizure was 4.3 days (range 0-13 days). There was no significant association between tumor grade and the rate of perioperative seizure (Grade I, 0%; II, 7.0%; III, 6.1%; IV, 5.2%; p = 0.665). A single ictal episode occurred in 11 patients, while 3 patients experienced 2 seizures and 4 patients developed 3 or more seizures. Compared with their seizure-free counterparts, patients who experienced a perioperative seizure had an increased average hospital (6.8 vs 3.6 days, p = 0.032) and ICU LOS (5.4 vs 2.3 days; p < 0.041). Seventy-five percent of seizure-free patients were discharged home in comparison with 55.6% of seizure patients (p = 0.068). Patients with a postoperative seizure were significantly more likely to visit the emergency department within 90 days (44.4% vs 19.0%; OR 3.41 [95% CI 1.29-9.02], p = 0.009) and more likely to be readmitted within 90 days (50.0% vs 18.4%; OR 4.45 [95% CI 1.69-11.70], p = 0.001). In addition, seizure-free patients had a longer median overall survival (15.6 months [interquartile range 6.6-24.4 months] vs 3.0 months [interquartile range 1.0-25.0 months]; p = 0.013). CONCLUSIONS Patients with perioperative seizures following glioma resection required longer hospital and ICU LOS, were r...

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Section: Seizures and Health Care Quality Accountabilitymentioning

confidence: 99%

Perioperative seizure in patients with glioma is associated with longer hospitalization, higher readmission, and decreased overall survival

Dewan¹,

White-Dzuro²,

Brinson³

et al. 2016

JNS

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“…The incidence rates of seizures in meningiomas, especially in atypical and malignant subtypes, remain understudied [10]. 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].…”

Section: Introductionmentioning

confidence: 99%

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

Attas¹

2021

OAJNN

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Methods:In this hospital-based retrospective study, patients with brain tumors and drug-resistant epilepsy, which is defined as the failure of two tolerated and appropriately chosen antiepileptic drugs (whether as monotherapies or in combination) to achieve and alleviate sustained seizure freedom, were recruited. These patients underwent a thorough pre-surgical evaluation in an Epilepsy Monitoring Unit (EMU) before deciding to undergo surgical intervention according to an epilepsy case management conference.Results: One-hundred patients (including 45 children) with brain tumors were included in this study (male: female = 3:2). Most of the patients (93) had G/GNT. No significant differences in outcome were observed among sex, age, or histopathological categories. However, during the first year after epilepsy surgery, most of the low-grade G/GNT cases showed favorable outcomes based on ILAE classes 1 and 2 (61.3% and 9.7%, respectively), whereas high-grade gliomas and meningothelial tumors showed outcomes of ILAE class 1 (40% and 100%, respectively). Conclusion:Post-epilepsy surgical outcomes of different brain tumors have been achieved with favorable outcomes in children and adults with low-grade gliomas and meningiomas. Thus, pre-surgical evaluation in EMU is highly recommended to enhance better post-epilepsy surgical outcomes.

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“…[18] Treatment of tumor related epilepsy is a complex theme, however recent studies indicated that surgical management supersede medical management. [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.…”

Section: Introductionmentioning

confidence: 99%

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

Al-Attas¹,

Alhindi²,

AbaAlkhail³

et al. 2020

Preprint

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Background Some studies have suggested that tumor pathology significantly influence freedom from seizures post epilepsy surgery; however, there is no consensus among researchers regarding this issue. This study aims to retrospectively look for different types of tumor- related epilepsy and their outcomes in the first-year post epilepsy surgery among both adults and children. Methods In this hospital-based retrospective study, patients with drug resistant epilepsy due to brain tumor who underwent epilepsy surgery were included. Our patients underwent a thorough presurgical evaluation in an Epilepsy Monitoring Unit (EMU) before deciding to undergo surgical intervention, according to an epilepsy case-management conference. Four outcomes of interest were investigated during the first-year post epilepsy surgery.Results One hundred patients with brain tumors were included in this study (male: female = 3:2); 45 patients were children. Most of the patients (93) had low-grade gliomas or glioneuronal tumors (G/GNT). No significant differences in outcome were observed between sex, age, or histopathological categories. However, during the first year after epilepsy surgery most of the low-grade G/GNT cases showed favorable outcomes of International League Against Epilepsy (ILAE) class 1 and 2 (61.3% and 9.7%, respectively), while high-grade gliomas and meningothelial tumors showed outcomes of ILAE class 1 (40% and 100%, respectively). Conclusions One-year favorable outcome of post epilepsy surgery of different brain tumors have been achieved among both children and adults. Adequate presurgical evaluation in EMU (for long-term video-electroencephalography monitoring) to plan appropriate surgical strategy is advised. Tumor Pathology does not influence seizure outcome one-year post epilepsy surgery.

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Brain Tumor and Seizures: Incidence, Pathophysiology, Diagnosis and Treatment

Cited by 3 publications

References 65 publications

Perioperative seizure in patients with glioma is associated with longer hospitalization, higher readmission, and decreased overall survival

Perioperative seizure in patients with glioma is associated with longer hospitalization, higher readmission, and decreased overall survival

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

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

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