Chronic epilepsy due to low grade temporal lobe tumors and due to hippocampal sclerosis: Do they differ in post-surgical outcome?
Chronic seizures as a presenting feature of low grade temporal lobe gliomas and hippocampal sclerosis (HS) are reported to have similar outcomes although the prognostic indicators may not be the same. This study seeks to identify the variables that are associated with poor surgical outcome in both c...
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| Veröffentlicht in: | Journal of neuro-oncology 2013-11, Vol.115 (2), p.225-231 |
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| creator | Vannemreddy, Prasad S. S. V. Kanner, Andres M. Smith, Michel C. Rossi, Marvin Wallace, David Vannemreddy, Siddharth N. K. Byrne, Richard W. |
| description | Chronic seizures as a presenting feature of low grade temporal lobe gliomas and hippocampal sclerosis (HS) are reported to have similar outcomes although the prognostic indicators may not be the same. This study seeks to identify the variables that are associated with poor surgical outcome in both conditions. A retrospective analysis from our epilepsy data base was performed. All low-grade temporal lobe gliomas were selected and relevant variables were compared to the same variables in HS patients. There were 34 tumors (out of 233 cases of chronic temporal lobe epilepsy = 14.6 %) with a mean age of onset of 19 years, and the preoperative duration was 12.3 years. When compared to 120 HS patients both of these factors were significantly different (
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| doi_str_mv | 10.1007/s11060-013-1217-0 |
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p
< 0.001). Age at the time of surgery for tumors was 31.08 (
p
= 0.5). Tumors were left sided in 20 patients. In tumor cases amygdala resection was complete in 75 %, for hippocampus 24 % were complete and 39 % partial. Astrocytoma, ganglioglioma and oligodendroglioma constituted 80 % of tumor cases. Good outcome (Engel’s Class I) was achieved in 88.2 % of tumor cases and 71 % of HS cases while poor outcome (Class III + IV) was seen in 5.9 and 16.7 % respectively. The follow up period for the two groups was not significantly different. In multivariate logistic regression analysis, the groups differed significantly in preoperative delay (between diagnosis and surgery) and in epilepsy outcome. Chronic temporal lobe epilepsy due to low-grade tumors had significantly better surgical outcome with considerably less preoperative delay. The age of onset of seizures was younger in HS patients but a delay in surgical treatment was significantly longer. Given that the diagnosis of treatment-resistant TLE secondary to HS can be established after two failed AED trials at optimal doses, shortening the interval between diagnosis and surgery may improve epilepsy outcome.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-013-1217-0</identifier><identifier>PMID: 23955571</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adolescent ; Adult ; Brain Neoplasms - complications ; Brain Neoplasms - pathology ; Brain Neoplasms - surgery ; Clinical Study ; Epilepsy, Temporal Lobe - etiology ; Epilepsy, Temporal Lobe - pathology ; Epilepsy, Temporal Lobe - surgery ; Female ; Follow-Up Studies ; Hippocampus - pathology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Neoplasm Grading ; Neurology ; Neurosurgical Procedures ; Oncology ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Sclerosis - complications ; Sclerosis - pathology ; Sclerosis - surgery</subject><ispartof>Journal of neuro-oncology, 2013-11, Vol.115 (2), p.225-231</ispartof><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-dc7a3effa965181ca0b3c534d8e961b87b291e2cffa006ee94fce2ee787004a53</citedby><cites>FETCH-LOGICAL-c405t-dc7a3effa965181ca0b3c534d8e961b87b291e2cffa006ee94fce2ee787004a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11060-013-1217-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11060-013-1217-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23955571$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vannemreddy, Prasad S. S. V.</creatorcontrib><creatorcontrib>Kanner, Andres M.</creatorcontrib><creatorcontrib>Smith, Michel C.</creatorcontrib><creatorcontrib>Rossi, Marvin</creatorcontrib><creatorcontrib>Wallace, David</creatorcontrib><creatorcontrib>Vannemreddy, Siddharth N. K.</creatorcontrib><creatorcontrib>Byrne, Richard W.</creatorcontrib><title>Chronic epilepsy due to low grade temporal lobe tumors and due to hippocampal sclerosis: Do they differ in post-surgical outcome?</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Chronic seizures as a presenting feature of low grade temporal lobe gliomas and hippocampal sclerosis (HS) are reported to have similar outcomes although the prognostic indicators may not be the same. This study seeks to identify the variables that are associated with poor surgical outcome in both conditions. A retrospective analysis from our epilepsy data base was performed. All low-grade temporal lobe gliomas were selected and relevant variables were compared to the same variables in HS patients. There were 34 tumors (out of 233 cases of chronic temporal lobe epilepsy = 14.6 %) with a mean age of onset of 19 years, and the preoperative duration was 12.3 years. When compared to 120 HS patients both of these factors were significantly different (
p
< 0.001). Age at the time of surgery for tumors was 31.08 (
p
= 0.5). Tumors were left sided in 20 patients. In tumor cases amygdala resection was complete in 75 %, for hippocampus 24 % were complete and 39 % partial. Astrocytoma, ganglioglioma and oligodendroglioma constituted 80 % of tumor cases. Good outcome (Engel’s Class I) was achieved in 88.2 % of tumor cases and 71 % of HS cases while poor outcome (Class III + IV) was seen in 5.9 and 16.7 % respectively. The follow up period for the two groups was not significantly different. In multivariate logistic regression analysis, the groups differed significantly in preoperative delay (between diagnosis and surgery) and in epilepsy outcome. Chronic temporal lobe epilepsy due to low-grade tumors had significantly better surgical outcome with considerably less preoperative delay. The age of onset of seizures was younger in HS patients but a delay in surgical treatment was significantly longer. Given that the diagnosis of treatment-resistant TLE secondary to HS can be established after two failed AED trials at optimal doses, shortening the interval between diagnosis and surgery may improve epilepsy outcome.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Brain Neoplasms - complications</subject><subject>Brain Neoplasms - pathology</subject><subject>Brain Neoplasms - surgery</subject><subject>Clinical Study</subject><subject>Epilepsy, Temporal Lobe - etiology</subject><subject>Epilepsy, Temporal Lobe - pathology</subject><subject>Epilepsy, Temporal Lobe - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hippocampus - pathology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Grading</subject><subject>Neurology</subject><subject>Neurosurgical Procedures</subject><subject>Oncology</subject><subject>Postoperative Complications</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Sclerosis - complications</subject><subject>Sclerosis - pathology</subject><subject>Sclerosis - surgery</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1rFTEUhoMo9rb6A9xIwI2baD4nEzdSrtYKBTctuAuZzJl7U2YmMZlBuvSfm8ttRQShq3CS57yHkwehV4y-Y5Tq94Ux2lBCmSCMM03oE7RhSguihRZP0YayRhNl5PcTdFrKLaVUasGeoxMujFJKsw36td3nOAePIYURUrnD_Qp4iXiMP_Euu74WMKWY3VivulqtU8wFu7l_IPchpejdlCpS_Ag5llA-4E8RL3uoeWEYIOMw4xTLQsqad8FXNK6LjxN8fIGeDW4s8PL-PEM3F5-vt5fk6tuXr9vzK-IlVQvpvXYChsGZRrGWeUc74ZWQfQumYV2rO24YcF8JShsAIwcPHEC3uq7tlDhDb4-5KccfK5TFTqF4GEc3Q1yLZVK1SlJu9CNQKYyRrWgr-uYf9Dauea6LHChueCvNYTY7Ur5-Tskw2JTD5PKdZdQeVNqjSltV2oNKS2vP6_vktZug_9Px4K4C_AiU-jTvIP81-r-pvwGpGqow</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Vannemreddy, Prasad S. S. V.</creator><creator>Kanner, Andres M.</creator><creator>Smith, Michel C.</creator><creator>Rossi, Marvin</creator><creator>Wallace, David</creator><creator>Vannemreddy, Siddharth N. 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V. ; Kanner, Andres M. ; Smith, Michel C. ; Rossi, Marvin ; Wallace, David ; Vannemreddy, Siddharth N. 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S. V.</au><au>Kanner, Andres M.</au><au>Smith, Michel C.</au><au>Rossi, Marvin</au><au>Wallace, David</au><au>Vannemreddy, Siddharth N. K.</au><au>Byrne, Richard W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic epilepsy due to low grade temporal lobe tumors and due to hippocampal sclerosis: Do they differ in post-surgical outcome?</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>115</volume><issue>2</issue><spage>225</spage><epage>231</epage><pages>225-231</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Chronic seizures as a presenting feature of low grade temporal lobe gliomas and hippocampal sclerosis (HS) are reported to have similar outcomes although the prognostic indicators may not be the same. This study seeks to identify the variables that are associated with poor surgical outcome in both conditions. A retrospective analysis from our epilepsy data base was performed. All low-grade temporal lobe gliomas were selected and relevant variables were compared to the same variables in HS patients. There were 34 tumors (out of 233 cases of chronic temporal lobe epilepsy = 14.6 %) with a mean age of onset of 19 years, and the preoperative duration was 12.3 years. When compared to 120 HS patients both of these factors were significantly different (
p
< 0.001). Age at the time of surgery for tumors was 31.08 (
p
= 0.5). Tumors were left sided in 20 patients. In tumor cases amygdala resection was complete in 75 %, for hippocampus 24 % were complete and 39 % partial. Astrocytoma, ganglioglioma and oligodendroglioma constituted 80 % of tumor cases. Good outcome (Engel’s Class I) was achieved in 88.2 % of tumor cases and 71 % of HS cases while poor outcome (Class III + IV) was seen in 5.9 and 16.7 % respectively. The follow up period for the two groups was not significantly different. In multivariate logistic regression analysis, the groups differed significantly in preoperative delay (between diagnosis and surgery) and in epilepsy outcome. Chronic temporal lobe epilepsy due to low-grade tumors had significantly better surgical outcome with considerably less preoperative delay. The age of onset of seizures was younger in HS patients but a delay in surgical treatment was significantly longer. Given that the diagnosis of treatment-resistant TLE secondary to HS can be established after two failed AED trials at optimal doses, shortening the interval between diagnosis and surgery may improve epilepsy outcome.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23955571</pmid><doi>10.1007/s11060-013-1217-0</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Adult Brain Neoplasms - complications Brain Neoplasms - pathology Brain Neoplasms - surgery Clinical Study Epilepsy, Temporal Lobe - etiology Epilepsy, Temporal Lobe - pathology Epilepsy, Temporal Lobe - surgery Female Follow-Up Studies Hippocampus - pathology Humans Male Medicine Medicine & Public Health Neoplasm Grading Neurology Neurosurgical Procedures Oncology Postoperative Complications Prognosis Retrospective Studies Sclerosis - complications Sclerosis - pathology Sclerosis - surgery |
| title | Chronic epilepsy due to low grade temporal lobe tumors and due to hippocampal sclerosis: Do they differ in post-surgical outcome? |
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