Seizure Outcome After Surgery for Insular High-Grade Glioma

Pepper, Joshua; Cuthbert, Hadleigh; Scott, Teresa; Ughratdar, Ismail; Wykes, Victoria; Watts, Colin; D’Urso, Pietro Ivo; Karabatsou, Konstantina; Moor, C. E. De; Albanese, Erminia

doi:10.1016/j.wneu.2021.07.114

Cited by 4 publications

(8 citation statements)

References 37 publications

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“… Panigrahi et al (2021) 61 Epilepsy: 34 (55.7%), motor deficit: 7 (11.5%), dysphasia: 7 (11.5%), intracranial hypertension: 11 (18.0%) GBM: 12 (19.7%), anapl. : 7 (11.5%), LGG: 42 (65.6%), WHO°I: 0, other: 0 4 (6.6%) 4 (6.6%) NA NA NA Pepper et al (2021) 38 Epilepsy: 9 (23.7%), motor deficit: 0, dysphasia: 3 (7.9%), intracranial hypertension: 2 (5.3%) GBM: 12 (31.6%), anapl. : 26 (68.4%), LGG: 0, WHO°I: 0, other: 0 4 (10.5%) 2 (5.3%) NA NA NA Pitskhelauri et al (2021) 79 Epilepsy: 58 (73.4%), motor deficit: 3 (3.8%), dysphasia: 4 (5.1%), intracranial hypertension: 1 (1.3%) GBM: 15 (19.0%), anapl.…”

Section: Resultsmentioning

confidence: 99%

“… 176 (69.6%) Przybylowski et al (2020) 100 NA Berger-Sanai TS (52, 52.0%), TOP (48, 48.0%) 52 (52.0%) Neuronavigation: 100 (100%), fMRI, DTI, electrostim., awake (mean EOR, trans-sylvian vs. not: 91.6 vs. 88.6%) Singh et al (2023) 27 18 (33.3%) Yasargil, Berger-Sanai TS (13, 48.1%), TOP (14, 51.9%) 13 (48.1%) Neuronavigation: 4 (14.8%), US: 4 (14.8%), iopM (MEPs): 3 (11.1%), electrostim. : 3 (11.1%) 16 (59.3%) Leroy et al (2021) 20 NA Berger-Sanai TOP, TT 0 Neuronavigation, fMRI, iopMRI: 20 (100%) 12 (60.0%) Pallud et al (2021) 149 (111 resection & 38 biopsy cases) 138/149 (92.6%) Yasargil, Berger-Sanai TOP (111, 100%) 0 Neuronavigation: 111/149 (74.5%), US, awake: 61/149 (40.9%) 21 (14.1%) Panigrahi et al (2021) 61 NA Berger-Sanai TS (38, 62.3%), TOP (23, 37.7%) 38 (62.3%) Neuronavigation, fMRI, DTI, electrostim., ICG angio: 61 (100%) 38 (62.3%) Pepper et al (2021) 38 NA Berger-Sanai NA NA iopM: 11 (28.9%), awake: 27 (71.1%) 6 (15.8%) Pitskhelauri et al (2021) …”

Section: Resultsmentioning

confidence: 99%

“…The rate of temporary deficits is high and several publications describe neurological improvement over time. Specifically, early motor and language deficit rates in series describing >50 surgeries varied between 8.1 - 37.5% and 4.3–50.1% ( Duffau, 2009 ; Eseonu et al, 2017 ; Hameed et al, 2019 ; Hervey-Jumper et al, 2016 ; Kawaguchi et al, 2014 ; Lang et al, 2001 ; Leroy et al, 2021 ; Li et al, 2020 ; Majchrzak et al, 2011 ; Moshel et al, 2008 ; Özyurt et al, 2003 ; Pallud et al, 2021 ; Pepper et al, 2021 ; Pitskhelauri et al, 2021 ; Przybylowski et al, 2020 ; Rao et al, 2018 ; Rossi et al, 2021 ; Sanai et al, 2010 ; Simon et al, 2009 ; Skrap et al, 2012 ; Sughrue et al, 2017 ; Sughrue et al, 2016 ; Sun et al, 2022 ; Zhuang et al, 2016 ). The majority of neurological complications seems to be caused by ischemia due to small vessel compromise, i.e.…”

Section: Resultsmentioning

confidence: 99%

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Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section

Simon,

Hagemann,

Gajadin

et al. 2024

Brain and Spine

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section

Simon,

Hagemann,

Gajadin

et al. 2024

Brain and Spine

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“…An instance of this are lesions in the region of the insular cortex which historically have been considered too high risk to approach due to the surrounding critical structures. New results show that excision of high-grade gliomas in the insula can be safe and result in good postoperative seizure control [ 41 ].…”

Section: Effects Of Surgery On Seizuresmentioning

confidence: 99%

Seizure Management and Prophylaxis Considerations in Patients with Brain Tumors

Hauff

Storstein

2023

Curr Oncol Rep

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Purpose of Review The article gives an overview of the current knowledge in the management of tumor related epilepsy, including systematic reviews and consensus statements as well as recent insight into a potentially more individualized treatment approach. Recent Findings Tumor molecular markers as IDH1 mutation and MGMT methylation status may provide future treatment targets. Seizure control should be included as a metric in assessing efficacy of tumor treatment. Summary Prophylactic treatment is recommended in all brain tumor patients after the first seizure. Epilepsy has a profound effect on the quality of life in this patient group. The clinician should tailor the choice of seizure prophylactic treatment to the individual patient, with the goal of limiting adverse effects, avoiding interactions and obtaining a high degree of seizure freedom. Status epilepticus is associated with inferior survival and must be treated promptly. A multidisciplinary team should treat patients with brain tumors and epilepsy.

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“…Use of intraoperative electrocorticography significantly improved seizure freedom rates in glioma patients [ 16 ]. Previously considered inaccessible tumors in the insular region can usually be successfully accessed and resected with improved imaging and intra-operative monitoring techniques and lead to comparable seizure freedom rates as cortically located tumors [ 17 ]. Seizure recurrence after initial postoperative seizure control is associated with tumor progression [ 6 , 7 , 18 ], but by surgical re-resection patients can regain seizure control [ 19 ].…”

Section: Effect Of Antitumor Treatment On Seizure Controlmentioning

confidence: 99%

Management of epilepsy in brain tumor patients

Meer

Taphoorn

Koekkoek

2022

Current Opinion in Oncology

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Purpose of reviewA concise review of recent findings in brain tumor-related epilepsy (BTRE), with focus on the effect of antitumor treatment on seizure control and the management of antiepileptic drugs (AEDs).Recent findingsIsocitrate dehydrogenase mutation and its active metabolite d-2-hydroxyglutarate seem important contributing factors to epileptogenesis in BTRE. A beneficial effect of antitumor treatment (i.e. surgery, radiotherapy, and chemotherapy) on seizure control has mainly been demonstrated in low-grade glioma. AED prophylaxis in seizure-naïve BTRE patients is not recommended, but AED treatment should be initiated after a first seizure has occurred. Comparative efficacy randomized controlled trials (RCTs) are currently lacking, but second-generation AED levetiracetam seems the preferred choice in BTRE. Levetiracetam lacks significant drug-drug interactions, has shown favorable efficacy compared to valproic acid in BTRE, generally causes no hematological or neurocognitive functioning adverse effects, but caution should be exercised with regard to psychiatric adverse effects. Potential add-on AEDs in case of uncontrolled seizures include lacosamide, perampanel, and valproic acid. Ultimately, in the end-of-life phase when oral intake of medication is hampered, benzodiazepines via nonoral administration routes are potential alternatives.SummaryManagement of seizures in BTRE is complex and with currently available evidence levetiracetam seems the preferred choice. Comparative efficacy RCTs in BTRE are warranted.

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Seizure Outcome After Surgery for Insular High-Grade Glioma

Cited by 4 publications

References 37 publications

Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section

Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section

Seizure Management and Prophylaxis Considerations in Patients with Brain Tumors

Management of epilepsy in brain tumor patients

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