Low-grade glial neoplasms and intractable partial epilepsy: efficacy of surgical treatment.
We performed a retrospective study of 51 consecutive patients who underwent operation for intractable partial epilepsy related to low-grade intracerebral neoplasms between 1984 and 1990. All patients had medically refractory partial seizures and a mass lesion identified on neuroimaging studies. Lesionectomy was performed on 17 patients, and 34 had lesion resection and corticectomy. Mean postoperative follow-up was 4.4 years (range 2-8 years). Sixty-six percent of patients were seizure-free, and 88% experienced a significant reduction in seizure frequency. In 16 patients (31%), antiepileptic drugs (AEDs) were successfully discontinued. Twenty-five of 31 (81%) eligible patients obtained a driver's license after successful operation. Patients with complete tumor resection and no interictal epileptiform activity on postoperative EEG studies had the best operative outcome. Epilepsy surgery can result in long-term improvement in seizure control and quality of life (QOL) in selected patients with intractable tumor-related epilepsy. Our results should be useful to clinicians considering treatment options for patients with intractable seizures related to low-grade intracerebral neoplasms.
Britton
J W
JW
Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905.
Cascino
G D
GD
Sharbrough
F W
FW
Kelly
P J
PJ
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002540:Cerebral Cortex / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome