Seizure characteristics and control following resection in 332 patients with low-grade gliomas

Abstract

The majority of patients with LGG present with seizures; in approximately half of these patients, the seizures are pharmacoresistant before surgery. Postoperatively, >90% of these patients are seizure free or have meaningful improvement. A shorter history of seizures and gross-total resection appear to be associated with a favorable prognosis for seizure control.

Long‐term surgical outcomes of temporal lobe epilepsy associated with low‐grade brain tumors

“…Although some authors reported that good seizure control can be obtained despite incomplete tumor resection, 11,12 the importance of total tumor removal for seizure control has been emphasized by many authors, especially in recent studies. 4,5,13 However, Daumas-Duport et al 14 reported…”

Seizures in Children with Brain Tumours — Epidemiology, Significance, Management, and Outcomes

“…The lone series in which this was not true was that reported by Hirsch et al, in which complex and simple partial seizures together only accounted for half of all cases [118]. The percentages generally reported for children and adolescents are somewhat different than for adults, in whom tumour-associated seizures tend to be more evenly distributed across the four most typical seizure types [58]. Other atypical and, therefore, less well recognized forms of seizure have been described in children as well, including gelastic seizures, characterized by uncontrolled fits of inappropriate laughter [45], tics and Tourrette-like symptoms [119], and sympathetic storms in a 7-year old with a midbrain glioma [120].…”

“…Clearly, such surgery needs to be performed as soon after diagnosis of the lesion as possible to have any effect upon outcome. Such is not the case in many patients with low-grade tumours like stage I and II gliomas and gangliogliomas, in whom progression of the tumour may be so slow as to be virtually undetectable, and patients can live for years without apparent disease progression, so that any decision to surgically remove the offending lesion may be delayed for years [58,93,148,149]. This being said, there has been increasing emphasis on surgically resecting low-grade tumours early in the course of disease [131] for a multiplicity of reasons.…”

“…This creates dilemmas as to how aggressive to be, and therefore how much risk to take in their resection [55]. As well, the return of seizures at some distant time postoperatively may indicate tumour growth or relapse [28,30,[56][57][58][59][60][61][62][63][64][65][66], transformation into a more aggressive lesion [28,60,65,67,68], or even the emergence of a secondary (e.g., radiationinduced) tumour [64].…”

Neuronavigation applied to epilepsy monitoring with subdural electrodes

“…20 When a brain tumor is associated with epilepsy, the extent of resection has been related to a better seizure outcome. 5 Image guidance can be particularly valuable when epilepsy surgery involves a lesion that is relatively indistinct, or not at all visible macroscopically, as in cases of epilepsy in association with subtle cortical dysplasia, or in cases of focal epilepsy not associated with any anatomical lesion, such as EZs localized only by electrographic data, metabolic studies, or magnetic source localization. Imaging with PET, SPECT, or MEG can be fused with a structural MR image and used for naviga-tion 2,3,8,12,13 to enhance the accurate localization of the hypothesized EZ.…”