Tumor-related epilepsy and post-surgical outcomes: tertiary hospital experience in Vietnam

Abstract

Seizures have a significant impact on the quality of life of those who suffer. This study aimed to evaluate the variables that influence the incidence of seizures during the perioperative period and effective measures to enhance epilepsy outcomes among individuals undergoing surgical resection of brain tumors. The authors carried out a prospective observational analysis of all patients who experienced seizures before their brain tumor surgery at UMC, HCMC between 2020 and 2022. 54 cases presented with seizures were enrolled for the study, generalized seizure was the most prevalent seizure type (61.1%), followed by focal seizure (29.6%). The majority of patients presented with seizures are those who were diagnosed with glioma. Low-grade gliomas and frontotemporal lobe tumors increase the postoperative risk of seizure. Other predictive factors are a prolonged history of seizure, especially resistant epilepsy and major peritumoral edema. In contrast, gross total resection reduces postoperative seizure incidence. There was correlation between Ki67 proliferation index and seizure incidence in both low-grade and high-grade gliomas. ECoG made insubstantial difference in enhancing the epilepsy surgery outcome. Overall, 88.9% of patients were seizure-free at 6 months of follow-up (Engel Class I), 7.4% were almost seizure-free (Class II), and 3.7% had significant improvement (Class III), figures for 12-month follow-up were 87.0%, 9.3%, and 3.7% respectively. A shorter history of seizure and gross-total resection appear to be associated with a favorable prognosis for seizure control.

Epilepsy in Patients With Primary CNS Lymphoma

“…Tumor location is not the only source of epileptogenicity in PCNSL because a high proliferation index (Ki-67 ≥90%) has also been identified as an independent risk factor of seizures as a secondary manifestation, similar to what has been reported for glioblastoma. 26 It has been hypothesized that PCNSL molecular subtyping, 17 with its specific oncogenic pathways, distinct transcriptomic and epigenetic signatures, preferential tumor location, and prognostic significance, could be a potential factor in epileptogenesis. However, epilepsy was not associated with a particular molecular cluster, although molecular subtyping was explored in only 20% of the patients in our cohort.…”