Surgical treatment of drug-resistant epilepsy caused by gliomas in eloquent areas: experience report.
Arq Neuropsiquiatr
; 77(11): 797-805, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31826136
ABSTRACT
INTRODUCTION:
Drug-resistant epilepsy associated with central nervous system tumors is generally caused by low grade gliomas. This group of tumors is usually found in brain eloquent areas, such as the insular lobe, rolandic cortex and supplementary motor area and, historically, possess a greater risk of postoperative deficits.OBJECTIVE:
The aim of this investigation was to present our surgical experience on patients with drug-resistant epilepsy caused by gliomas in eloquent areas. We retrospectively investigated variables that impact seizure control, such as tumor location, extent of resection, invasion into the lenticulostriate arteries in the patient, especially those with insular gliomas.METHODS:
Out of 67 patients with eloquent area brain tumors operated on in our service between 2007 and 2016, 14 patients had symptoms of drug-resistant epilepsy. Volumetric analysis, extent of resection (EOR), type of approach and mapping, among other factors were correlated with the 12-month postoperative seizure outcome.RESULTS:
Univariate analysis showed that the factors showing statistical relevance with seizure control were preoperative volume (p = 0.005), EOR (p = 0.028) and postoperative volume (p = 0.030).CONCLUSION:
There was a statistically significant association between the EOR and the Engel score for epilepsy control an EOR < 70 was associated with Engel II, III, IV and an EOR > 90 was associated with Engel I. Eloquent area gliomas can safely be resected when surgeons use not only microsurgical anatomy concepts but also brain mapping.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Encefálicas
/
Epilepsia Resistente a Medicamentos
/
Glioma
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Arq Neuropsiquiatr
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Brasil