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Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection.

Publication ,  Journal Article
Berger, MS; Ghatan, S; Haglund, MM; Dobbins, J; Ojemann, GA
Published in: J Neurosurg
July 1993

Adults and children with low-grade gliomas often present with medically refractory epilepsy. Currently, controversy exists regarding the need for intraoperative electrocorticography (ECoG) to identify and, separately, resect seizure foci versus tumor removal alone to yield maximum seizure control in this patient population. Forty-five patients with low-grade gliomas and intractable epilepsy were retrospectively analyzed with respect to preoperative seizure frequency and duration, number of antiepileptic drugs, intraoperative ECoG data (single versus multiple foci), histology of resected seizure foci, and postoperative control of seizures with or without antiepileptic drugs. Multiple versus single seizure foci were more likely to be associated with a longer preoperative duration of epilepsy. Of the 45 patients studied, 24 were no longer taking antiepileptic drugs and were seizure-free (mean follow-up interval 54 months). Seventeen patients, who all had complete control of their seizures, remained on antiepileptic drugs at lower doses (mean follow-up interval 44 months); seven of these patients were seizure-free postoperatively, yet the referring physician was reluctant to taper the antiepileptic drugs. Four patients continued to have seizures while receiving antiepileptic drugs, although at a reduced frequency and severity. In this series 41% of the adults versus 85% of the children were seizure-free while no longer receiving antiepileptic drugs, with mean postoperative follow-up periods of 50 and 56 months, respectively. This difference was statistically significant (p = 0.016). Therefore, based on this experience and in comparison with numerous retrospective studies involving similar patients, ECoG is advocated, especially in children and in any patient with a long-standing seizure disorder, to maximize seizure control while minimizing or abolishing the need for postoperative antiepileptic drugs.

Duke Scholars

Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

July 1993

Volume

79

Issue

1

Start / End Page

62 / 69

Location

United States

Related Subject Headings

  • Postoperative Period
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Glioma
  • Female
  • Epilepsy
  • Electroencephalography
  • Child, Preschool
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Berger, M. S., Ghatan, S., Haglund, M. M., Dobbins, J., & Ojemann, G. A. (1993). Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection. J Neurosurg, 79(1), 62–69. https://doi.org/10.3171/jns.1993.79.1.0062
Berger, M. S., S. Ghatan, M. M. Haglund, J. Dobbins, and G. A. Ojemann. “Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection.J Neurosurg 79, no. 1 (July 1993): 62–69. https://doi.org/10.3171/jns.1993.79.1.0062.
Berger MS, Ghatan S, Haglund MM, Dobbins J, Ojemann GA. Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection. J Neurosurg. 1993 Jul;79(1):62–9.
Berger, M. S., et al. “Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection.J Neurosurg, vol. 79, no. 1, July 1993, pp. 62–69. Pubmed, doi:10.3171/jns.1993.79.1.0062.
Berger MS, Ghatan S, Haglund MM, Dobbins J, Ojemann GA. Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection. J Neurosurg. 1993 Jul;79(1):62–69.

Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

July 1993

Volume

79

Issue

1

Start / End Page

62 / 69

Location

United States

Related Subject Headings

  • Postoperative Period
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Glioma
  • Female
  • Epilepsy
  • Electroencephalography
  • Child, Preschool