Abstract
Background Glial brain tumors (GBT) adjacent to motor cortical areas (MCA) are associated with tumor-related epilepsy (TRE). We analyzed aspects of intraoperative motor mapping (IOMM) in the presence of epileptiform activity in the peritumoral zone. Material and methods We studied 41 patients (m/f = 18/23, age 18–77) with GBT located in the MCA were analyzed. All patients underwent tumor resection in Polenov Russian Neurosurgical Institute in 2014–2016. IOMM was performed utilizing “IOM ISIS” hardware (Inomed, Germany). The trial group included 30 patients with TRE. Eleven patients in control group had GBT without TRE. Motor function was assessed postoperatively according to a conventional 6-grade score. Impairment degree and duration were estimated. Results The presence of TRE does not reduce the possibility of the motor response during IOMM (odds ratio – 1.0 (95% confidence interval 0.2 – 4.3)). However, current levels sufficient for IOMM in the trial group were significantly higher than in control group (22 – 25 mA vs 16 – 20 mA respectively; p Conclusions IOMM in patients with TRE is performed while motor neurons are in the state of altered reactivity. This state is associated with higher current levels for IOMM. It may also contribute to a more significant transient motor deficit in the early postoperative period.
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