Abstract
AB083. Epilepsy and low-grade glioma-seizure control after surgical resection: a retrospective cohort study
Saqib Kamran Bakhshi1, Rabeet Tariq1, Faiza Urooj1, Safwan Masood1, Farhan Arshad Mirza2,3, Syed Ather Enam1
1Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan;
2Department of Neurosurgery, Kentucky Neuroscience Institute (KNI), University of Kentucky, Lexington, KY, USA;
3UK Comprehensive Epilepsy Program, University of Kentucky, Lexington, KY, USA
Correspondence to: Syed Ather Enam, MD, PhD, FRCSI, FRCSC, FRCSG, FACS. Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Sadium Road, Karachi, Pakistan. Email: ather.enam@aku.edu.
Background: Seizures are a common manifestation in patients with low grade glioma (60–75%), and 60–90% patients attain seizure freedom after resection. Seizure control varies with histopathology, extent of resection and type of seizures. There is inconsistency in literature regarding utility of anti-epileptic drugs (AEDs) after tumor resection. We aimed to determine factors associated with seizure control in patients after low-grade glioma (LGG) resection.
Methods: It was a retrospective cohort study. Medical record of all patients who underwent LGG resection at our center from 2019 to 2021 were reviewed; 77 patients fulfilled the selection criteria. Patients were also contacted via phone calls to collect information about their seizure control as per Engel Classification. Data was analyzed using SPSSv21.
Results: The mean age was 34.9±11.3 years, and there was male predominance (62; 80.5%). Generalized seizures were the most common type (54; 70%), and Levetiracetam was the most commonly prescribed AED (60; 77.9%). The median duration of pre-operative AED use was 4 [interquartile range (IQR): 1–24] months. Frontal lobe was the most common location of tumor (36; 46.8%). Most of the patients had their surgery under general anesthesia (51; 61.4%), while 29 (37.7%) underwent awake craniotomy. Nearly half of the patients had a gross total resection (31; 40.3%), and another 15 (19.5%) had near-total resection. Sixteen patients (20.8%) had their AEDs stopped within first 6 months post-operatively (at variable intervals), and all of them had Engel Class IA to ID control at time of follow-up (P=0.008). The 12 patients with grade I glioma also had optimum seizure control (P=0.03).
Conclusions: Patients with grade I glioma have better seizure control after surgery. Tumor biopsy is associated with worse seizure outcome, though not statistically significant. Larger studies are needed to determine the ideal time and patient group for discontinuing AED after surgery.
Keywords: Low grade glioma (LGG); low-grade glioma (LGG); seizure control; epilepsy surgery
Acknowledgments
Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab083/coif). The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. This study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and was approved by the Ethical Review Board of the Aga Khan University Hospital, Karachi, Pakistan (2023-7141-24593). Because of the retrospective nature of the research, the requirement for informed consent was waived.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
Cite this abstract as: Bakhshi SK, Tariq R, Urooj F, Masood S, Mirza FA, Enam SA. AB083. Epilepsy and low-grade glioma-seizure control after surgical resection: a retrospective cohort study. Chin Clin Oncol 2024;13(Suppl 1):AB083. doi: 10.21037/cco-24-ab083
