Abstract
AimTo analyze the incidence of epilepsy in adult patients with supratentorial glioblastoma, assess the factors influencing the development of epilepsy in these cases, and evaluate patients’ response to antiepileptic drugs (AEDs) in a series of 184 patients.MethodsWe retrospectively analyzed the 184 adult patients diagnosed with supratentorial glioblastoma. All subjects were treated within our hospital and subsequently died between 2003 and 2013. The incidence of epilepsy was assessed before and after initial resection and reexamined every 2 months thereafter. We evaluated the efficacy of prophylactic AEDs in this patient population based on the gathered incidence data.ResultsOf 184 patients, 43 (23.37%) were diagnosed with epilepsy before their initial resection. The total incidence of epilepsy (both pre- and postoperative) was 68.48%. The prevalence of active epilepsy reached over 80% in patients with epilepsy and survival of greater than 13 months postoperatively. Patients with glioblastoma in the frontal and/or temporal lobes had a higher prevalence of epilepsy. In the 43 patients with preoperative epilepsy, total resection of glioblastoma resulted in significantly lower seizure frequency. Patients who received epilepsy prophylaxis with AEDs for at least 6 months had significantly fewer seizures and higher Karnofsky scores than those receiving AEDs for less than one month or not at all.ConclusionThe incidence of epilepsy in adult patients with glioblastoma was high and responded poorly to AEDs in the short term. However, when taken for longer periods, AEDs can reduce the frequency of seizures in patients with glioblastoma.
Highlights
Glioblastoma multiforme (GBM) is the most common primary intracranial tumor, and is characterized by aggressive growth and high patient morbidity.1 Extensive resection of intracranial tumors is challenging and collateral damage to normal brain tissue is a significant risk
The prevalence of active epilepsy reached over 80% in patients with epilepsy and survival of greater than 13 months postoperatively
Patients with glioblastoma in the frontal and/or temporal lobes had a higher prevalence of epilepsy
Summary
Glioblastoma multiforme (GBM) is the most common primary intracranial tumor, and is characterized by aggressive growth and high patient morbidity. Extensive resection of intracranial tumors is challenging and collateral damage to normal brain tissue is a significant risk. Glioblastoma multiforme (GBM) is the most common primary intracranial tumor, and is characterized by aggressive growth and high patient morbidity.. Research continues to provide progress, the long-term survival of patients with GBM is rarely a reality due to frequent tumor recurrence. [3,4] The low incidence of epilepsy in GBM compared to low grade gliomas is frequently reported in the literature. [1, 5,6,7,8] epilepsy, when present, can be an important marker of tumor progression in GBM patients. [9] Reports on the cumulative incidence of epilepsy throughout the entire progression of GBM, from initial presentation to eventual death from the disease, are rare. We analyze the incidence of epilepsy, the factors influencing its development, and its response to AEDs
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