Introduction: Low grade tumors are a frequent cause of refractory epilepsy. The authors reviewed the outcome of patients with low grade tumors who underwent epilepsy surgery.
Methods: Retrospective analysis of the patients with a low-grade tumor who underwent epilepsy surgery in Centro Hospitalar de Lisboa Ocidental, from 2003 to 2017. The variables analyzed were: the demographic data, lesion location, type of surgery, histopathologic diagnose, complications and surgery outcome according to the Engel classification.
Results: 40 patients underwent surgery during this period. The mean age at the time of surgery was 20 years (between 3 and 55 years), and 22 (55%) were male patients. Lesionectomy was performed in 34 patients and anterior temporal lobectomy in 6 patients. There were complications in 4 patients: hematoma, third nerve palsy and hemiparesis. The hystopathological diagnosis was: 18 dysembryoplastic neuroepithelial tumours (DNET), 14 ganglioglioma, 5 oligodendroglioma, and 3 astrocytoma. The most frequent location was the temporal lobe, in 85% (n=34) of patients. After a mean follow-up of 20 months, the outcome according to Engel Classification was: 80% (n=32) patients in class I, 15% (n=6) in class II and 3% (n=1) in class IV. One case of mortality was reported, two months after surgery, in a patient with an oligodendroglioma. DNET was the lesion associated with a better outcome, with 94% (n=17) of patients in Engel class I after surgery.
Conclusions: In refractory epilepsy secondary to low grade tumors, surgery was effective in reducing seizure frequency, notably in patients with DNETs.
Patient Care: Increase awareness and indications for Epilepsy Surgery
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Recognize the role of surgery in low grade tumours related epilepsy 2) Identify lesions susceptible to better outcomes 3) Recognize potential side effects