title: Seizure Freedom Rates and Prognostic Indicators After Resection of Gangliogliomas: A Review.
abstract: Gangliogliomas are rare tumors that comprise up to 40% of lesional epilepsy. Seizure control represents an important quality-of-life determinant in patients with these tumors. Here we present results of a literature review addressing rates of seizure freedom in in patients with gangliogliomas. Across studies, seizure freedom occurred in 63%-100% of patients. Many studies included follow-up times of greater than 5 years, suggesting that the responses are durable. We discuss potential prognostic factors associated with seizure freedom, including the duration of epilepsy, patient age, frequency and semiology of seizures, tumor location, extent of surgical resection, and operative strategy, including surgical approach and use of invasive monitoring. Although significant differences in study populations and treatments preclude meta-analysis, we discuss prognostic factors identified in individual studies. Increased extent of resection, lesser duration of epilepsy, and younger age at surgery have been associated with increased seizure freedom rates in at least 2 studies each. Although all studies were retrospective in nature and are consequently limited by the weaknesses inherent to such investigations, the literature suggests that surgery is able to relieve most ganglioglioma patients--regardless of patient demographics, tumor characteristics, and operative variables--of seizures.
authors.affiliation: Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Phillip A
authors.initials: PA
authors.lastname: Bonney
authors.affiliation: Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Glenn
authors.affiliation: Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ebeling
authors.affiliation: Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Conner
authors.affiliation: Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Lillian B
authors.initials: LB
authors.lastname: Boettcher
authors.affiliation: Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Drew M
authors.initials: DM
authors.lastname: Cameron
authors.affiliation: Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Oklahoma Comprehensive Brain Tumor Clinic, Stephenson Cancer Center, Oklahoma City, OK, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Battiste
authors.affiliation: Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Oklahoma Comprehensive Brain Tumor Clinic, Stephenson Cancer Center, Oklahoma City, OK, USA. Electronic address: michael-sughrue@ouhsc.edu.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Sughrue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018303:Ganglioglioma / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Epilepsy; Ganglioglioma; Outcomes; Resection; Seizure; Surgery