Tumor-associated epilepsy

Rajneesh, Kiran; Binder, Devin K.

doi:10.3171/2009.5.focus09101

Cited by 46 publications

(27 citation statements)

References 41 publications

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“…For example, hypoxia and acidosis, ionic changes, and deposition of hemosiderin in the peritumoral region have also been suggested as potential mechanisms affecting epileptogenesis in gliomas [47,48,69]. A complex alteration of the GABAergic system, also involving the perilesional epileptic cortex, has been reported in patients with GG [88,89] and a recent study supports the key role of CCTs in tumor-related epilepsy [90].…”

Section: Epileptogenesismentioning

confidence: 90%

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Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Aronica

Crino

2014

Neurotherapeutics

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Section: Epileptogenesismentioning

confidence: 90%

“…Both clinical and experimental studies suggest the involvement of multiple mechanisms, including both tumor-related factors (tumor size, tumor location) and peritumoral changes ( [47][48][49]; Fig. 3).…”

Section: Epileptogenesismentioning

confidence: 99%

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Aronica

Crino

2014

Neurotherapeutics

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“…18,19 The presence of irritative substances in the first weeks following surgery, such as hemosiderin deposits, inflammatory substances, edema, and/or electrolytic disturbances might explain the appearance of seizures in this critical time. 25,41 However, in the current literature, there are no clear data with regard to the epilepsy risk related to surgery in ILGG. In our series, we observed that only 1 patient (4.7%) experienced a single partial seizure after ILGG resection.…”

Section: Risk Of Seizures In the Early Postoperative Periodmentioning

confidence: 99%

Is there a risk of seizures in “preventive” awake surgery for incidental diffuse low-grade gliomas?

Lima

Duffau

2015

JNS

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A WHO Grade II glioma (diffuse low-grade glioma [LGG]) is a continuously growing lesion that migrates along white matter pathways and that will inescapably evolve toward a higher grade of malignancy. 39This tumor is usually revealed by inaugural seizures in young adults with no or only mild neurological deficits. 11Despite the lack of prospective randomized trials, a large amount of data reported in the modern literature strongly supports the impact of early and maximal resection on the natural history of the disease, by delaying malignant transformation and thus by significantly increasing survival. 1,15,20,21,30,46,49 Recently the French Glioma Network published the largest surgical series of LGG ever reported, in which multivariate analysis was used to show that extent abbreviatioNs AED = antiepileptic drug; EOR = extent of resection; ILGG = incidental low-grade glioma; KPS = Karnofsky Performance Scale. submitted June 22, 2014. accepted September 10, 2014. iNclude wheN citiNg Published online February 27, 2015; DOI: 10.3171/2014.9.JNS141396. disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.Is there a risk of seizures in "preventive" awake surgery for incidental diffuse low-grade gliomas? obJect Although a large amount of data supports resection for symptomatic diffuse low-grade glioma (LGG), the therapeutic strategy regarding incidental LGG (ILGG) is still a matter of debate. Indeed, early "preventive" surgery has recently been proposed in asymptomatic patients with LGG, after showing that the extent of resection was larger than in symptomatic patients with LGG. However, the quality of life should be preserved by avoiding both neurological deficit and epilepsy. The aim of this study was to determine the risk of seizures related to such a prophylactic surgical treatment in ILGG. methods The authors report a prospective series of 21 patients with ILGG who underwent awake surgery with a minimum follow-up of 20 months following resection. Data regarding clinicoradiological features, surgical procedures, and outcomes were collected and analyzed. In particular, the eventual occurrence and type of seizures in the intra- and postoperative periods were studied, as follows: early (< 3 months) and long-term (until last follow-up) periods. results There were no intraoperative seizures in this series. During the early postoperative period, the authors observed only a single episode of partial seizures in a patient with no antiepileptic drug (AED) prophylaxis-all other patients were given antiepileptic treatment following resection. The AEDs were discontinued in all cases, with a mean delay of 8 months after surgery (range 3-24 months). No patient had permanent neurological deficits. All 21 patients returned to an active familial, social, and professional life (working full time in all cases). Total or even "supratotal" resection (the latter meaning that a margin around the tumor visible on FLAIR-weighted MRI was removed) ...

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“…22,24,44,47,48,51,57 One of the earliest described mechanisms is the mass effect, with compression of surrounding brain parenchyma causing ischemia, hypoxia, and acidosis, which modify neuron excitability. 1,11,62,66 Recently, more attention has been given to structural changes in peritumoral tissue.…”

Section: Clinical Role Of Peritumoral Infiltrated Tissuementioning

confidence: 99%

Surgery for insular low-grade glioma: predictors of postoperative seizure outcome

Ius

Pauletto

Isola

et al. 2014

JNS

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Object. Although a number of recent studies on the surgical treatment of insular low-grade glioma (LOG) have demonstrated that aggressive resection leads to increased overall patient survival and decreased malignant progression, less attention has been given to the results with respect to tumor-related epilepsy. The aim of this investigation was to evaluate the impact of volumetric, histological, and intraoperative neurophysiological factors on seizure outcome in patients with insular LGG. \ud Methods. The authors evaluated predictors of seizure outcome with special emphasis on both the extent of tumor resection (EOR) and the tumor's infiltrative pattern quantified by computing the difference between the preoperative T2- and Ti-weighted MR images (Delta VT2T1) in 52 patients with preoperative drug-resistant epilepsy. \ud Results. The 12-month postoperative seizure outcome (Engel class) was as follows: seizure free (Class I), 67.31%; rare seizures (Class II), 7.69%; meaningful seizure improvement (Class III), 15.38%; and no improvement or worsening (Class IV), 9.62%. Poor seizure control was more common in patients with a longer preoperative seizure history (p < 0.002) and higher frequency of seizures (p = 0.008). Better seizure control was achieved in cases with EOR >= 90% (p < 0.001) and Delta VT2T1 < 30 cm(3) (p < 0.001). In the final model, Delta VT2T1 proved to be the strongest independent predictor of seizure outcome in insular LGG patients (p < 0.0001). \ud Conclusions. No or little postoperative seizure improvement occurs mainly in cases with a prevalent infiltrative tumor growth pattern, expressed by high Delta VT2T1 values, which consequently reflects a smaller BOR

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Tumor-associated epilepsy

Cited by 46 publications

References 41 publications

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Epilepsy Related to Developmental Tumors and Malformations of Cortical Development

Is there a risk of seizures in “preventive” awake surgery for incidental diffuse low-grade gliomas?

Surgery for insular low-grade glioma: predictors of postoperative seizure outcome

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