Artikel
Low-grade gliomas presenting with pharmaco-resistant epilepsy: a different subgroup of low-grade gliomas
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Veröffentlicht: | 20. Mai 2009 |
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Objective: Patients with low-grade gliomas have 5-year survival rates from 42 to 92%. Patients with pharmaco-resistant epilepsy (PRE) due to LGG usually have a mean preoperative history of epilepsy longer than 10 years and some authors reported a 10-year postoperative recurrence free survival rate of 100% regardless of the extent of surgery. The authors investigated the preoperative and postoperative history of patients with LGG presenting only with PRE.
Methods: One hundred five patients with PRE were operated on in the Department of Neurosurgery, University Hospital “St. Ivan Rilski”, Sofia between 1998–2007. Thirty-one patients were with PRE as the only presenting complaint of LGG.
Results: Age of seizure onset ranged from 2 to 53 years (mean 23 years) and age at the time of operation ranged from 5 to 60 years (mean 31 years). The average epilepsy duration was 8 years (from 1 to 26 years). Seven patients had history of pharmaco-resistant epilepsy longer than 10 years. Surgical treatment consisted of complete tumor resection in 20 patients and incomplete resection in 11 patients. Complete seizure control (Engel class I) was achieved in 66%. The mean follow-up was 5 years (from 1 to 9 years). Two patients presented tumor progression 5 years after surgery and were reoperated for high-grade glioma.
Conclusions: LGG appear as a heterogeneous group of tumors. Patients with LGG presenting with PRE have frequently a long preoperative and postoperative history without tumor progression. The different clinical behaviour of these lesions suggests different location, size, histopathological findings, immunohistochemistry and molecular biology.