Factors affecting seizure outcome in Long-term epilepsy associated tumors (LEATs) in children and young adolescents

Mehrotra, Anant; Singh, Shanker K.; Kanjilal, Soumen; Pal, Lili; Paliwal, Vimal Kumar; Sardhara, Jayesh; Verma, Pawan Kumar; Maurya, Ved Prakash; Bhaisora, Kamlesh Singh; Das, Kuntal Kanti; Srivastava, Arun Kumar; Jaiswal, Awadhesh Kumar; Behari, Sanjay

doi:10.1016/j.clineuro.2020.106104

Cited by 10 publications

(7 citation statements)

References 31 publications

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“…A previous article from our center analyzed postsurgical 12-month seizure outcomes and neuropsychological outcomes in a partially overlapping patient population that underwent temporal lobe surgery (31). The present study aligns with previous studies, confirming that a complete lesion resection is an important prognostic factor which influences seizure control after surgery (14,16,(32)(33)(34)(35)(36)(37). This effect is likely more pronounced when taking into account that only patients with at least a 12-month FU were included in this study, and several patients who did not achieve satisfactory outcomes after the first surgery also underwent a second surgery, however, notably shorter than the 12-month FU, leading to their exclusion from the primary evaluation.…”

Section: Discussionsupporting

confidence: 88%

Long-term seizure outcome after epilepsy surgery of neuroglial tumors

Rácz,

Müller,

Becker

et al. 2024

Front. Neurol.

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PurposeNeuroglial tumors are frequently associated with pharmacorefractory epilepsies. However, comprehensive knowledge about long-term outcomes after epilepsy surgery and the main prognostic factors for outcome is still limited. We sought to evaluate long-term outcomes and potential influencing factors in a large cohort of patients who underwent surgery for neuroglial tumors in a single-center setting.MethodsThe study analyzed the outcomes of 107 patients who underwent epilepsy surgery for neuroglial tumors between 2001 and 2020 at the Department of Epileptology, University Hospital Bonn, in Germany. The outcomes were evaluated using Engel classification. Differences in outcome related to potential prognostic factors were examined using the Chi2-test, Fisher’s exact test and sign test. Additionally, stepwise logistic regression analysis was employed to identify independent prognostic factors.ResultsComplete seizure freedom (Engel Class IA) was achieved in 75% of the operated patients at 12 months, and 56% at the last follow-up visit (70.4 ± 6.2 months, median: 40 months). Completeness of resection was a crucial factor for both 12-month follow-up outcomes and the longest available outcomes, whereas lobar tumor localization, histology (ganglioglioma vs. dysembryoplastic neuroepithelial tumor), history of bilateral tonic–clonic seizures prior to surgery, invasive diagnostics, side of surgery (dominant vs. non-dominant hemisphere), age at epilepsy onset, age at surgery, and epilepsy duration did not consistently impact postsurgical outcomes. Among temporal lobe surgeries, patients who underwent lesionectomy and lesionectomy, including hippocampal resection, demonstrated similar outcomes.ConclusionNeuroglial tumors present as excellent surgical substrates in treating structural epilepsy. To achieve an optimal postsurgical outcome, a complete lesion resection should be pursued whenever possible.

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Section: Discussionsupporting

confidence: 88%

Long-term seizure outcome after epilepsy surgery of neuroglial tumors

Rácz,

Müller,

Becker

et al. 2024

Front. Neurol.

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“…Some clinical studies have reported that surgical resection can alleviate seizures in GG patients related to epilepsy ( 5 , 12 ), but a few patients still experience seizures ( 13 , 14 ). A previous clinical study demonstrated that patients benefit little from only reducing seizure frequency ( 15 ), and despite having undergone epilepsy surgery, the quality of life of patients with postoperative seizures was far worse than that of patients without seizures ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Seizure outcomes and prognostic factors in patients with gangliogliomas associated with epilepsy

Zhang

Adilijiang

et al. 2022

Front. Surg.

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IntroductionGanglioglioma (GG) patients often present with seizures. Although most patients can be seizure-free after tumor resection, some still experience seizures. The present study aimed to analyze a group of GGs patients associated with epilepsy and evaluate the seizure outcomes and prognostic factors.MethodsThis retrospective study involved clinical data collected from medical records of patients diagnosed with GG pathologically and underwent surgical resection in Sanbo Brain Hospital, Capital Medical University. The seizure outcomes were evaluated based on the International League Against Epilepsy (ILAE) seizure outcome classification. The prognostic factors were identified according to univariate and multivariate analysis.ResultsA total of 222 patients were included, with a mean age at surgery of 19.19 ± 10.93 years. All patients were followed up at least for one year with a mean follow-up duration of 6.28 ± 3.17 years. At the final follow-up, 174 (78.4%) patients achieved ILAE Class 1 or 2. Univariate and multivariate analyses revealed that the short duration of seizures and gross total resection were significant positive factors for seizure-free. Bilateral interictal or ictal epileptiform discharges in preoperative video-electroencephalogram (VEEG) were related to poor seizure outcomes.ConclusionSurgical resection is an effective treatment for patients with epilepsy associated with GGs. The analysis of predictive factors could effectively guide clinical practice and evaluate the prognosis of epilepsy with GG.

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“…These same factors-younger age, shorter duration of symptoms, and focal seizures-had been shown to have a better prognosis by other authors. [12][13][14] The analysis suggests that this heterogenous small subgroup of pathology at study has a clinical presentation, seizure outcome, and prognostic factors similar to cohorts of common pathologies causing temporal lobe epilepsy.…”

Section: Discussionmentioning

confidence: 96%

Lesional Temporal Lobe Epilepsy: Does the “Uncommon” Differ from the Common?

Kumar

Singh

Mehrotra

et al. 2022

Indian Journal of Neurosurgery

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Objectives This study aims to evaluate the subgroup consisting of uncommon pathological entities presenting with temporal lobe epilepsy (TLE). Methodology Twenty-four consecutively operated patients of lesional temporal lobe epilepsy were included in the study. Eleven cases were identified that had pathologies implicated as “uncommon” in previously done studies on the pathology of TLE. A subgroup analysis consisting of these uncommon lesions was done for clinical presentation and seizure outcome. The seizure outcome was assessed in terms of Engel and International League Against Epilepsy (ILAE) classification. Results Nine different pathological entities were identified within the study group. The mean age at surgery was 18.6 years (range 2–30 years). The mean duration of epilepsy was 48.3 months and the average duration of follow-up was 39.2months. All patients had seizures as the only complaint except three. Three patients had focal-aware seizures, two had focal motor onset, and the rest all had focal-unaware seizures. Seven patients were seizure free and the average age at diagnosis for these patients was 15.4 years (range 2–24 years.). The duration of seizure in the postoperative seizure-free group was 29.7 months and it was 81 months for the other group. All the patients with persistent postoperative seizures had focal-unaware seizures preoperatively. Conclusion Despite the small and heterogeneous nature of this subgroup of uncommon lesions causing temporal lobe epilepsy, the clinical presentation, prognostic factors, and seizure outcome are similar to the cohort of common pathologies, including mesial temporal sclerosis.

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Factors affecting seizure outcome in Long-term epilepsy associated tumors (LEATs) in children and young adolescents

Cited by 10 publications

References 31 publications

Long-term seizure outcome after epilepsy surgery of neuroglial tumors

Long-term seizure outcome after epilepsy surgery of neuroglial tumors

Seizure outcomes and prognostic factors in patients with gangliogliomas associated with epilepsy

Lesional Temporal Lobe Epilepsy: Does the “Uncommon” Differ from the Common?

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