Significance of chronic epilepsy in glial tumors and correlation with surgical strategies.
OBJECTIVE
This study was designed to compare the frequency of postoperative epilepsy in patients with acute and chronic pre-operative epilepsy and with frontal or temporal lobe glial tumors based on the hypothesis that patients with chronic epilepsy do worse.


METHODS
We compared the clinical and diagnostic characteristics of the patients (n = 73) who had seizures preoperatively with those of the patients (n = 153) who did not. Among those who have had seizures preoperatively, we compared those (n = 32, chronic seizure group) who had seizures a year or more prior to surgery with those (n = 41, acute seizure group) who had seizures less than a year prior to surgery.


RESULTS
Among the various factors, the frequency of benign pathology and favorable neurological state were higher in the seizure group than in the non-seizure group (p < 0.05). Complex partial seizures and low-grade tumors were frequent in the chronic seizure group, whereas simple partial seizures and high-grade tumors were frequent in the acute seizure group. Seizure-free rate was significantly higher in the acute seizure group than in the chronic group (p < 0.05). Also, the difference of seizure control rate between surgical strategies was statistically significant (p < 0.05).


CONCLUSIONS
This study indicates that preoperative seizure duration and frequency have a close relationship with the frequency of postoperative epilepsy in patients with glial tumors. A longer duration may allow the formation of epileptogenic foci, leading to chronic epilepsy, and eventually have a negative effect on the prognosis of the patients. Factors including histopathological characteristics of the tumor, its location, seizure duration/frequency, and symptomatology should be taken into account when deciding on surgical strategies.
Kim
Ok-Joon
OJ
Department of Neurology, Pundang CHA Hospital, Pochon CHA University, Pundang-gu, Sungnam, South Korea.
Yong Ahn
Jung
J
Chung
Young Sun
YS
Chung
Sang Sup
SS
Lee
Kyu Sung
KS
Choi
Joong Uhn
JU
Lee
Byung-In
BI
D000328:Adult; D001932:Brain Neoplasms / Q000150:complications* / Q000601:surgery; D002908:Chronic Disease; D004827:Epilepsy / Q000209:etiology*; D005260:Female; D005910:Glioma / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011184:Postoperative Period; D011379:Prognosis; D016896:Treatment Outcome