Predictors of preoperative and early postoperative seizures in patients with intra‐axial primary and metastatic brain tumors: A retrospective observational single center study

Skardelly, Marco; Brendle, Elina; Noell, Susan; Behling, Felix; Wuttke, Thomas V.; Schittenhelm, Jens; Bisdas, Sotirios; Meisner, Christoph; Rona, Sabine; Tatagiba, Marcos; Tabatabai, Ghazaleh

doi:10.1002/ana.24522

Cited by 73 publications

(70 citation statements)

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“…The main results of this study are that preoperative tumor volume of the contrast enhancing tumor (not the FLAIR-hyperintense edema) shows a significant correlation to seizures. This is in common with a previous study by Skardelly et al that showed a tumor volume <64 cm 3 as a main risk factor for the development of preoperative seizures [18]. Another study showed that this association was only found in high-grade gliomas, but not in low-grade gliomas where an inverse association between tumor volume and seizures was observed [17].…”

Section: Discussionsupporting

confidence: 88%

“…According to this study high grade gliomas presenting with neurologic symptoms instead of seizures were more likely to occur in the pericallosal region [17]. Interestingly other than previous studies, we found no significant associations between location in the left hemisphere and infiltration of the hippocampus was associated with preoperative seizure as shown in previous studies [18,31,32]. Main explanation for this finding might be that the cited previous studies mainly assessed low-grade gliomas whereas this study only investigated glioblastoma patients only.…”

Section: Discussioncontrasting

confidence: 60%

“…As seizures were shown to be associated with improved survival in high-grade glioma [31], it is of high importance to characterize the exact pathomechanisms causing seizures in glioma patients to develop new therapy strategies. Many studies investigated the pathomechanisms for brain tumor-related seizures [1,[9][10][11]13,16,18,31]. There are two main hypotheses: First, the mechanical compression of surrounding brain structures by the tumor mass might cause seizures which is supported by the findings that gross-total tumor resection is associated with seizure-control [31,32].…”

Section: Discussionmentioning

confidence: 99%

“…Also the peritumoral region has attracted attention in the pathophysiology of BTE [13][14][15][16]. Studies showed that high-grade glioma patients with smaller preoperative tumor size significantly more often presented with seizures, whereas for low-grade gliomas contradicting results were shown [17,18].…”

Section: Introductionmentioning

confidence: 99%

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Image Analysis Reveals Microstructural and Volumetric Differences in Glioblastoma Patients with and without Preoperative Seizures

Bette

Barz

Nham

et al. 2020

Cancers

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Purpose: Seizures related to tumor growth are common in glioma patients, especially in low-grade glioma patients this is often the first tumor manifestation. We hypothesize that there are associations between preoperative seizures and morphologic features (e.g., tumor size, location) and histogram features in patients with glioblastoma (GB). Methods: Retrospectively, 160 consecutive patients with initial diagnosis and surgery of GB (WHO IV) and preoperative MRI were analyzed. Preoperative MRI sequences were co-registered (T2-FLAIR, T1-contrast, DTI) and tumors were segmented by a neuroradiologist using the software ITK-snap blinded to the clinical data. Tumor volume (FLAIR, T1-contrast) and histogram analyses of ADC-and FA-maps were recorded in the contrast enhancing tumor part (CET) and the non-enhancing peritumoral edema (FLAIR). Location was determined after co-registration of the data with an atlas. Permutation-based multiple-testing adjusted t statistics were calculated to compare imaging variables between patients with and without seizures. Results: Patients with seizures showed significantly smaller tumors (CET, adj. p = 0.029) than patients without preoperative seizures. Less seizures were observed in patients with tumor location in the right cingulate gyrus (adj. p = 0.048) and in the right caudate nucleus (adj. p = 0.009). Significant differences of histogram analyses of FA in the contrast enhancing tumor part were observed between patients with and without seizures considering also tumor location and size. Conclusion: Preoperative seizures in GB patients are associated with lower preoperative tumor volume. The different histogram analyses suggest that there might be microstructural differences in the contrast enhancing tumor Cancers 2020, 12, 994 2 of 12 part of patients with seizures measured by fractional anisotropy. Higher variance of GB presenting without seizures might indicate a more aggressive growth of these tumors.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Image Analysis Reveals Microstructural and Volumetric Differences in Glioblastoma Patients with and without Preoperative Seizures

Bette

Barz

Nham

et al. 2020

Cancers

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“…Brain tumors, either primary or secondary, account for 5-20% of cases of seizures occurring for the first time in adult. 7,8,37 Seizure is the first symptom in 30% of brain tumors. In adult, a first seizure, particularly if focal should be evaluated by MRI for an occult brain tumor.…”

Section: -29mentioning

confidence: 99%

Etiological profile of adult onset seizures: a hospital based prospective study from Kashmir, India

et al. 2017

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Background: Adult onset seizure (AOS) is considered the epilepsy that start after the age of 18 years. It is a common neurological disorder with multiple etiologies. Objective was to study the etiologies, diagnosis and treatment of AOS in Kashmiri population and to compare its different clinical and etiological profiles in different age groups.Methods: All patients who developed seizure after the age of 18 years were recruited in the current prospective study. In total 144 subjects with AOS were included in this study. The study was done in the Neurology unit of Sher-i-Kashmir Institute of Medical Science, Srinagar- a tertiary care hospital in Kashmir, India from August 2014 to July 2016.Results: Among the 144 recruited subjects, the 25-34 years age group was more susceptible to onset seizures. Generalized tonic-clonic seizure with a percentage of 48.8% was the most common seizure type among the studied subjects. Gender wise males were more susceptible to intracerebral hemorrhage while as cerebral venous sinus thrombosis is more common among females. Among the infection group, encephalitis was a leading causal factor in 10 (6.9%) patients and age wise younger population is more susceptible to encephalitis and central nervous system, while prion disease was more frequent in subjects with age of ≥55. On comparing various cerebrovascular diseases and seizures, ICH was responsible in most number of subjects (12.5%). MRI and EEG (59.7% and 52.8% respectively) findings were abnormal in maximum number of subjects and both findings showed statistically a significant positive correlation (r=0.73; p=<0.01).Conclusions: Idiopathic factors are the main cause of AOS with EEG and MRI being the mainstay for identifying, classifying and localizing seizures among the study patients.

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Factors Influencing Outcome in Neurosurgical Anesthesia

Field

2019

Essentials of Neurosurgical Anesthesia &Amp; Critical Care

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Predictors of preoperative and early postoperative seizures in patients with intra‐axial primary and metastatic brain tumors: A retrospective observational single center study

Abstract: Based on the developed prognostic scores, seizure prophylaxis should be considered in high-risk patients and patient stratification for prospective studies may be feasible in the future.

Cited by 73 publications

References 23 publications

Image Analysis Reveals Microstructural and Volumetric Differences in Glioblastoma Patients with and without Preoperative Seizures

Image Analysis Reveals Microstructural and Volumetric Differences in Glioblastoma Patients with and without Preoperative Seizures

Etiological profile of adult onset seizures: a hospital based prospective study from Kashmir, India

Factors Influencing Outcome in Neurosurgical Anesthesia

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