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Risk factors for supratentorial glioma-associated seizure patterns
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Citation of this paper:张杰,吴建兵,杜春富,张德明,高晋健,冯文,王嗣松,张桓.Risk factors for supratentorial glioma-associated seizure patterns[J].Chinese Journal of Clinical Medicine,2019,26(5):745-749
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张杰,吴建兵,杜春富,张德明,高晋健,冯文,王嗣松,张桓 1.雅安市人民医院神经外科雅安6250002.西南医科大学附属成都市西区医院神经外科成都6100363.西南医科大学附属成都三六三医院神经外科成都610041 
Abstract:Objective:To investigate the response to postoperative anti-epilepsy treatment in patients with supratentorial glioma-related epilepsy. Methods:Clinical data of 234 patients with supratentorial glioma-related epilepsy from January 2014 to January 2018 were retrospectively analyzed. Postoperative seizure patterns include: no postoperative seizure; early postoperative seizure controlled within 6 months; fluctuating seizure; and never seizure-free. No seizure rate, no seizure duration, and subsequent recurrence rate were analyzed. Results:Among the patients, there were 119 cases (50.9%) without seizure, 29 cases (12.4%) with early seizure, 56 cases (23.9%) with fluctuating seizure, and 30 cases (12.8%) with persistent seizure. There were 71 cases (30.3%) of glioma pathological grade Ⅱ, 41 cases (17.5%) of grade Ⅲ, and 122 cases (52.1%) of grade Ⅳ. Compared with patients without seizure, histology of patients with early seizure progressed significantly (P<0.05). In patients with fluctuating seizure, the pathological level of tumor was higher, and preoperative seizures were more common and histological progress was more obvious (P<0.05). In patients with persistent seizures,preoperative epilepsy seizures and incomplete tumor resection were commmon (P<0.05). After 12 months of seizure relief, 39.4%, 63.4%, and 15.6% of grade Ⅱ, Ⅲ, and Ⅳ glioma patients experienced subsequent seizures respectively. Conclusions:Epilepsy after surgery in supratentorial glioma-associated epilepsy patients has specific risk factors. Patients with grade Ⅱ-Ⅲ gliomas are most likely to have epileptic seizures after surgery, and no seizure occurred with 12 months and then offen relapsed to grade Ⅱ-Ⅲ gliomas. The risk factors for never seizure-free are preoperative seizures and insufficient tumor resection.
keywords:glioma  tumor-related epilepsy  drug treatment  seizure
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