Postoperative outcomes of tumor-associated epileptic seizures in glioma patients

Abstract

Background. Epileptic seizures occur in 50–90 % of patients with low‑grade glioma and in 20–60 % of patients with glioblastoma. The presence of tumor‑associated epilepsy is one of the leading criteria affecting the quality of life of this cohort of patients. The study of risk factors for the formation and persistence of tumor‑associated epilepsy after surgical resection can contribute to the most adequate care for such patients in terms of freedom from seizures and the duration of the relapse‑free period.Aim. To study the features of epileptic seizures before surgical treatment, in remote cases of the postoperative period in patients with glioma.Materials and methods. Patients (n = 184) with histologically verified gliomas underwent total or non‑total microsur‑ gical removal of the tumor. The radicality of resection was assessed 1 month after the operation. The observation was carried out for 5 years.Results. All patients were divided into 4 groups. The 1st group consisted of 102 (55.42 %) patients whose seizures regressed after surgery; the 2nd group included 2 patients with the first seizures after surgery – 1 (0.54 %) in the early and 1 (0.54 %) in the late postoperative period; the 3rd group – 23 (12.5 %) patients with seizures both before and after surgery; the 4th group – 57 (31 %) patients without seizures. Total resection was performed significantly more often in the group with regressed seizures – in 79 (77.4 %) patients. The dynamics of the course of seizures did not depend on their initial nature and frequency. Twenty four (70,6 %) patients with new seizures had tumor recurrence, of which 15 (62.5 %) patients had seizure recurrence earlier than tumor recurrence based on RANO criteria.Conclusion. Tumor‑associated epilepsy is most common in low‑grade gliomas. Total resection allows to increase life expectancy and improve its quality by controlling seizures. The effectiveness of adjuvant treatment of this cohort of patients is directly related to the results of treatment of tumor‑associated epilepsy.