High-frequency oscillations in awake patients undergoing brain tumor-related epilepsy surgery

Feyissa, Anteneh M.; Worrell, Gregory A.; Tatum, William O.; Mahato, Deependra; Brinkmann, Benjamin H.; Rosenfeld, Steven S.; ReFaey, Karim; Bechtle, Perry S.; Quiñones‐Hinojosa, Alfredo

doi:10.1212/wnl.0000000000005216

Cited by 35 publications

(40 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One might hypothesize that more affected tissue will produce more pathological signals. One study found higher rates of HFOs in patients with IDH1 mutant tumors 20 . Our cohort only included one patient with an IDH1 mutant tumor, who showed both ripples and fast ripples but not at particularly high rates.…”

Section: Discussionmentioning

confidence: 99%

Can we use intraoperative high‐frequency oscillations to guide tumor‐related epilepsy surgery?

et al. 2021

View full text Add to dashboard Cite

Objective In people with low‐grade intrinsic brain tumors, an epileptic focus is often located close to the lesion. High‐frequency oscillations (HFOs) in electrocorticography (ECoG) might help to delineate this focus. We investigated the relationship between HFOs and low‐grade brain tumors and their potential value for tumor‐related epilepsy surgery. Methods We analyzed pre‐ and postresection intraoperative ECoG in 41 patients with refractory epilepsy and a low‐grade lesion. Electrodes were designated as overlying the tumor, adjacent resected tissue (peritumoral), or outside the resection bed using magnetic resonance imaging (MRI) and intraoperative photographs. We then used a semiautomated approach to detect HFOs as either ripples (80–250 Hz) or fast ripples (250–500 Hz). Results The rate of fast ripples was higher in electrodes covering tumor and peritumoral tissue than outside the resection (p = .04). Mesiotemporal tumors showed more ripples (p = .002), but not more fast ripples (p = .07), than superficial tumors. Rates of fast ripples were higher in glioma and extraventricular neurocytoma than in ganglioglioma or dysembryoplastic neuroepithelial tumor (DNET). The rate of ripples and fast ripples in postresection ECoG was not higher in patients with residual tumor tissue on MRI than those without. The rate of ripples in postresection ECoG was higher in patients with good than bad seizure outcome (p = .03). Fast ripples outside the resection and in post‐ECoG seem related to seizure recurrence. Significance Fast ripples in intraoperative ECoG can be used to help guide resection in tumor‐related epilepsy surgery. Preresection fast ripples occur predominantly in epileptogenic tumor and peritumoral tissue. Fast ripple rates are higher in glioma and extraventricular neurocytoma than in ganglioglioma and DNET.

show abstract

Section: Discussionmentioning

confidence: 99%

Can we use intraoperative high‐frequency oscillations to guide tumor‐related epilepsy surgery?

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Feyissa ve ark. [15] 2018'de yayınladıkları çalışmada; IDHmutant genotipin, IDH-wild (negatif ) genotip gliomlardan daha epileptojenik olduğunu savunmuşlardır. Literatürle uyumlu olarak; bazal ganglia ve insula yerleşimli tümörlerde ameliyat öncesi ve sonrası dönemde epileptik nöbet görülme insidansı, kortikal yerleşimli tümörlere göre daha az saptanmıştır.…”

Section: Discussionunclassified

Perioperative Epileptic Seizure Incidence in Glioma Patients

Akay¹

2018

Epilepsi

View full text Add to dashboard Cite

Objectives: The aim of this study was to evaluate the incidence of epileptic seizures in the perioperative period in patients who were diagnosed with a glial tumor. Methods: This was a retrospective clinical study of the hospital files of 39 patients diagnosed with glial tumors in a single clinic between January 2016 and March 2018 as well as the data of the first 3 months of postoperative control. The glial tumor histopathological subgroup, presence of an isocitrate dehydrogenase mutation, radiological treatment feasibility of the site, deep or cortical location, and operative method were analyzed in relation to the incidence of epileptic seizures. Results: Of the 39 patients included in this study, the male/female ratio was 25/14. In all, 22 patients were diagnosed with a glial tumor after an epileptic seizure and 17 patients were initially examined for other complaints and subsequently diagnosed with a glial tumor. The functional field localization of the glial tumor in the preoperative period and the superficial location in the postoperative period were found to be statistically significant regarding epileptic seizure frequency. Conclusion: Functional level, superficial localization, World Health Organization grade II, and awake craniotomy were correlated with decreased incidence of postoperative seizures in glioma cases. However, despite the postoperative use of antiepileptic drugs in these subgroups, the incidence of epileptic seizures varied between 27% and 50%.

show abstract

“…Tumors involving the cerebral cortex, particularly the motor cortex, are more likely to produce seizures than tumors in the deep gray matter, although the latter can also lead to seizures because of surrounding edema and mass effect . Seizures can be a significant source of quality‐of‐life impairment for patients with brain tumors …”

Section: Seizures In Patients Who Have Cancer With Brain Lesionsmentioning

confidence: 99%

“…11 Seizures can be a significant source of quality-of-life impairment for patients with brain tumors. [12][13][14][15] In addition to the brain lesions themselves, seizures can also be a byproduct of the treatment provided, including surgery, radiation, and systemic therapies. On the basis of retrospective analyses of neurosurgical records, the estimated incidence of seizures after craniotomy is between 15% and 20%.…”

Section: Seizures In Patients Who Have Cancer With Brain Lesionsmentioning

confidence: 99%

Seizures in patients with cancer

Castro

Milligan

2020

Cancer

View full text Add to dashboard Cite

Seizures are common in patients with cancer and either result from brain lesions, paraneoplastic syndromes, and complications of cancer treatment or are provoked by systemic illness (metabolic derangements, infections). Evaluation should include a tailored history, neurologic examination, laboratory studies, neuroimaging, and electroencephalogram. In unprovoked seizures, antiepileptic drug (AED) treatment is required, and a nonenzyme‐inducing AED is preferred. Treatment of the underlying cancer with surgery, chemotherapy, and radiation therapy also can help reduce seizures. Benzodiazepines are useful in the treatment of both provoked seizures and breakthrough epileptic seizures and as first‐line treatment for status epilepticus. Counseling for safety is an important component in the care of a patient with cancer who has seizures. Good seizure management can be challenging but significantly improves the quality of life during all phases of care, including end‐of‐life care.

show abstract

High-frequency oscillations in awake patients undergoing brain tumor-related epilepsy surgery

Abstract: HFOs are common in brain tumor-related epilepsy, and HFO rate may be a useful measure of epileptogenicity in gliomas. Our findings further support the notion that IDH1 mutant genotype is more epileptogenic than IDH1 wild-type genotype gliomas.

Cited by 35 publications

References 26 publications

Can we use intraoperative high‐frequency oscillations to guide tumor‐related epilepsy surgery?

Can we use intraoperative high‐frequency oscillations to guide tumor‐related epilepsy surgery?

Perioperative Epileptic Seizure Incidence in Glioma Patients

Seizures in patients with cancer

Contact Info

Product

Resources

About