%0 Journal Article
%T P10.01 Epilepsy following low grade glioma surgery
%J Archive of "Neuro-Oncology".
%D 2017
%R 10.1093/neuonc/nox036.319
%X Aims: Our aim was to review the role of prophylactic AEDs and the effect of surgical technique (awake craniotomy versus resection under general anaesthetic) on seizure outcomes in patients undergoing surgery for low grade glioma (LGG) Methods: In our retrospective study we included all patients aged >18 years with a confirmed diagnosis of WHO grade II glioma within a 3-year period. Seizure incidence was recorded in the early post-operative period (up to 10 days post operatively) and in the longer term (3 to 12 months). To investigate the effect of AED treatment, patients were categorised into 3 groups: patients pre-established on AEDs (minimum 2 weeks prior to surgery), those started on prophylactic AEDs prior to the surgery (within 24 hours prior to surgery) and those who were not prescribed AEDs during follow up. Results: A total of 135 patients met the inclusion criteria. In the early post-operative period, out of the 24 patients suffered seizures, only 1 patient who had total tumour resection (4.1%), 5 patients (20.8%) of those who had near-total resection, 11 patients (45.8%) of who underwent subtotal/partial and 7(29.1%) of those who had biopsy (p=0.03). During long term follow up, 40(29.6%) patients had seizures, 3 (7.5%) of those who had total resection, 8 (20%) of near-total resection, 18 (45%) of subtotal/partial and 11 (27.5%) of biopsies (p=0.005). 34 (25.2%) underwent awake craniotomy, and 101 (74.8%) underwent resection under GA. 26 of them (33.3%) were in pre-established group, 6 (28.6%) in the prophylactic group and 8(22.3%) in the no AED group (p=0.41). Awake craniotomy was associated with greater extent of resection(total and near total resection) compared to the GA (67.6% v/s 45.4%; OR = 2.5, p=0.028) 78 patients (57.8%) were pre-established on AEDs, 21 (15.6%) received prophylactic AED, and 36 patients (26.7%) no AEDs during follow up. 24 (17.8%) experienced seizures in the early postoperative period (defined as 10 days post-surgery). 4 patients on prophylactic AED group (19.1%); 14 patients on pre-established AED (17.9 %); and 6 (16.7%) in the no AED groups, no statistical significant difference was found between the three groups (p=0.97).; Prophylactic AED treatment did not reduce seizures in the early post-operative period (OR 1.10, p=0.87). Conclusions: Gross resection was associated with lower seizure incidence in the immediate post-operative period, and during long term follow-up. There was no significant difference in seizure incidence between patients treated with prophylactic AEDs and those who were not
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464093/