The risk of developing seizures before and after primary brain surgery of low- and high-grade gliomas

• Published in: Clinical neurology and neurosurgery Vol. 169; pp. 185 - 191
• Main Authors: Bech, Katrine Tholstrup, Seyedi, Jian Fernandes, Schulz, Mette, Poulsen, Frantz Rom, Pedersen, Christian Bonde
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2018; Elsevier Limited
• Subjects: Adult; Brain cancer; Brain Neoplasms - diagnosis; Brain Neoplasms - epidemiology; Brain Neoplasms - surgery; Brain tumors; Cognitive ability; Cohort Studies; Comorbidity; Convulsions & seizures; Denmark - epidemiology; Diabetes; Epilepsy; Female; Glioma; Glioma - diagnosis; Glioma - epidemiology; Glioma - surgery; Histology; Humans; Hypertension; Male; Middle Aged; Multivariate Analysis; Neoplasm Grading - methods; Neuro-oncology; Neurology; Neurosurgery; NMR; Nuclear magnetic resonance; Patients; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Retrospective Studies; Risk Factors; Seizing; Seizure; Seizures - diagnosis; Seizures - epidemiology; Surgery; Thalamus; Treatment Outcome; Tumors; Denmark; Neuro-oncology; Seizure; Neurosurgery; Glioma; Epilepsy; Risk factors
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2018.04.024

•37.6% of patients had preoperative seizures, while 18.4% had postoperative seizures.•Symptoms and tumor size ≥ 40 mm are significant predictors of preoperative seizures.•Tumor location is a significant predictor of both pre- and postoperative seizures.•Pre- and perioperative seizures are significant predictors of postoperative seizures. To identify risk factors for developing seizures pre- and postoperatively in low- and high-grade gliomas. 282 patients undergoing neurosurgical tumor resection between 2013–2015 were included in the present single-center retrospective cohort study. Seizure incidences according to various variables were described. Univariate and multivariate logistic regression analyses were performed to identify significant risk factors for both pre- and postoperative seizures. 37.6% of patients presented with seizures before surgery, 18.4% developed seizures in the postoperative course, and 55.0% had no record of seizures pre- or postoperatively. Focal, cognitive, and other symptoms, tumors located in a non-eloquent area, and tumors ≥ 40 mm in diameter were found to be associated with a reduced risk of preoperative seizures, whereas hypertension or no comorbidity posed an increased risk. The presence of seizures pre- or perioperatively (≤ 24 h before and after surgery), and tumors located in the thalamus were associated with an increased risk of seizures in the postoperative course. Predictors for pre- and postoperative seizures identified in this study should be taken into account and integrated into the present knowledge, when determining patients at increased risk of developing seizures. Future prospective studies investigating the efficacy of prophylactic antiepileptic therapy in subgroups of glioma patients are needed before applied into clinical practice.