The Efficacy of Surgery for Supra-Tentorial Gliomas in Preventing Seizures

Authors

  • Muhammad Tariq
  • Adnan Munir
  • Mushtaq Ahmad Mian
  • Muhammad Farooq
  • Irfan Jan
  • Faiqa Filza

DOI:

https://doi.org/10.36552/pjns.v26i1.653

Abstract

Objectives:  The study examined the surgical outcome of supratentorial gliomas in terms of improvement in seizures in patients who presented to a tertiary care institution.

Material and Methods:  A descriptive case series was conducted in Neurosurgery Department at Northwest General Hospital & Research, Peshawar. Patients (n = 95) with supratentorial gliomas with seizures between 18 – 70 years were included. Supratentorial gliomas were diagnosed by neuroimaging as MRI brain with contrast, diffusion-weighted, Fluid-attenuated inversion recovery, and magnetic resonance spectroscopy. The patient was observed for seizures postoperatively. Data was stratified for age and gender.

Results:  The majority of patients (36.8%) were in 41 – 50 years. 55.78% of patients were males whereas 44.21% of patients were females. 42 (44.21%) involved the frontal lobe, 16 (16.84%) involved the parietal lobe, 26 (27.36%) involved the temporal lobe, and 11 (11.57%) patients involved the occipital lobe. According to Engel’s classification, 53 patients were in class I, 16 in class II, 10 in class III, and 5 in class IV. 84 (88.42%) experienced post-op seizure reduction. An insignificant association was found with the seizure improvement (yes/no) with different age groups and gender.

Conclusion:  The frontal lobe was the most prevalent location for supratentorial gliomas. After surgery, a large proportion of patients improved in terms of seizure management.

Keywords:  Seizures, Supratentorial gliomas.

References

Buckner J, Giannini C, Eckel-Passow J, Lachance D, Parney I, Laack N, Jenkins R. Management of diffuse low-grade gliomas in adults—use of molecular diagnostics. Nature Rev Neurol. 2017; 13 (6): 340.

Alifieris C, Trafalis DT. Glioblastoma multiforme: Pathogenesis and treatment. Pharmacology & therapeutics, 2015; 152: 63-82.

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN. Int J Cancer 2015; 136: 359-86.

Duffau H. Resecting diffuse low-grade gliomas to the boundaries of brain functions: a new concept in surgical neuro-oncology. J Neurosurg Sci. 2015; 59 (4): 361-71.

Fisher BJ, Hu C, Macdonald DR, Lesser GJ, Coons SW, Brachman DG, et al. Phase 2 study of temozolomide-based chemoradiation therapy for high-risk low-grade gliomas: preliminary results of Radiation Therapy Oncology Group 0424. Int J Rad Oncol. 2015; 91 (3): 497-504.

Krishnatry R, Zhukova N, Guerreiro Stucklin AS, Pole JD, Mistry M, Fried I, Ramaswamy V, Bartels U, Huang A, Laperriere N, Dirks P. Clinical and treatment factors determining long?term outcomes for adult survivors of childhood low-grade glioma: a population?based study. Cancer, 2016; 122 (8): 1261-9.

Moots PL, Maciunas RJ, Eisert DR, Parker RA, Laporte K, Abou-Khalil B. The course of seizure disorders in patients with malignant gliomas. Arch Neurol. 1995; 52 (7): 717-24.

Kahlenberg CA, Fadul CE, Roberts DW, Thadani VM, Bujarski KA, Scott RC, Jobst BC. Seizure prognosis of patients with lowgrade tumors. Seizure, 2012; 21 (7): 540-5.

Khattak MI, Khan BZ, Rehman ZU, Ali M. Surgical outcome of supratentorial gliomas. Khyber Med Univ J. 2016; 8 (4): 181.

Ul Haq N, Ali M, Usman M, Zar Khan B, Azam F. Surgical outcome of supratentorial low grade gliomas: study of 85 cases. J Postgrad Med Inst. 2016; 26; 30 (4).

Liigant A, Haldre S, Oun A, et al. Seizure disorders in patients with brain tumors. Eur Neurol. 2001; 45: 46–51.

Patsalos PN, Perucca E. Clinically important drug interactions in epilepsy: interactions between antiepileptic drugs and other drugs. Lancet Neurol. 2003; 2: 473–

Prayson RA. Diagnostic challenges in the evaluation of chronic epilepsy-related surgical neuropathology. Am J Surg Pathol. 2010; 34: e1–e13.

Fazekas F. Magnetic resonance signal abnormalities in asymptomatic individuals: Their incidence and functional correlates. Eur Neurol. 1989; 29: 164–8.

van Breemen MS, Rijsman R, Taphoorn M, Walchenbach R, Zwinkels H, Vecht CJ. Efficacy of anti-epileptic drugs in patients with gliomas and seizures. J Neurol. 2009; 256: 1519-26.

Rossetti AO, Jeckelmann S, Novy J, Roth P, Weller M, Stupp R. Levetiracetam and pregabalin for antiepileptic monotherapy in patients with primary brain tumors. A phase II randomized study. Neurooncol. 2003; 30 (6 Suppl): 45-8.

Lee YJ, Kim T, Bae SH, Kim YH, Han JH, Yun CH, et al. Levetiracetam compared with valproic acid for the prevention of postoperative seizures after supratentorial tumor surgery: A retrospective chart review. CNS Drugs, 2013; 27: 753-9.

Rossi G, Scerrati M, Roselli R. Epileptogenic cerebral low-interstitial stereotactic irradiation on seizures. Stereotact Func Neurosurg. 1986; 48: 127-32.

Rogers LR, Morris HH, Lupica K. Effect of cranial irradiation on seizure frequency in adults with low-grade astrocytoma and medically intractable epilepsy. Neurology, 1993; 43: 1599-601.

Koekkoek JA, Kerkhof M, Dirven L, Heimans JJ, Reijneveld JC, Taphoorn MJ. Seizure outcome after radiotherapy and chemotherapy in low-grade glioma patients: A systematic review. Neuro Onco. 2015; 17: 924-34.

Avila EK, Chamberlain M, Schiff D, Reijneveld JC, Armstrong TS, Ruda R, et al. Seizure control as a new metric in assessing efficacy of tumor treatment in low-grade glioma trials. Neuro Oncol. 2017; 19: 12-21.

Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000; 342: 314-9.

Englot DJ, Berger MS, Barbaro NM, Chang EF. Predictors of seizure freedom after resection of supratentorial low-grade gliomas: A review. J Neurosurg. 2011; 115: 240-4.

Englot DJ, Chang EF. Rates and predictors of seizure freedom I resective epilepsy surgery: Anupdate. Neurosurg Rev. 2014; 37: 389-405.

Jennum P, Dhuna A, Davies K, Fiol M, Maxwell R. Outcome of resective surgery for intractable partial epilepsy guided by subdural electrode arrays. Acta Neurol Scand. 1993; 87: 434-7.

Khattak MI, Khan BZ, Rehman ZU, Ali M. surgical outcome of supratentorial gliomas in terms of improvement in seizures during six months follow up. Khyber Medical University Journal, 2016; 8 (4): 181-.

Kahlenberg CA, Fadul CE, Roberts DW, Thadani VM, Bujarski KA, Scott RC, Jobst BC. Seizure prognosis of patients with low-grade tumors. Seizure, 2012; 21 (7): 540-5.

Chang EF, Potts MB, Keles GE, Lamborn KR, Chang SM, Barbaro NM, Berger MS. Seizure characteristics and control following resection in 332 patients with low-grade gliomas. Journal of Neurosurg. 2008; 108 (2): 227-35.

Luyken C, Blümcke I, Fimmers R, Urbach H, Elger CE, Wiestler OD, et al. The spectrum of long-term epilepsy–associated tumors: Long-term seizure and tumor outcome and neurosurgical aspects. Epilepsia. 2003; 44: 822-30.

Spencer S, Huh L. Outcomes of epilepsy surgery in adults and children. The Lancet Neurology, 2008; 7 (6): 525-37.

Bjørnæs H, Stabell KE, Heminghyt E, Røste GK, Bakke SJ. Respective surgery for intractable focal epilepsy in patients with low IQ: predictors for seizure control and outcome with respect to seizures and neuropsychological and psychosocial functioning. Epilepsia. 2004; 45 (2): 131-9.

Téllez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain, 2005; 128 (5): 1188-98.

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Published

2022-03-31

Issue

Vol. 26 No. 1 (2022): Vol. 26 No. 1 (2022): January- March

Section

Brain

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