QOL-02EPILEPSY FOLLOWING LOW GRADE GLIOMA SURGERY: SINGLE CENTRE EXPERIENCE

Abstract

OBJECTIVE: Review the incidence of seizures and the value of prophylactic antiepileptic drug (AED) treatment following surgery for Low Grade Gliomas (LGGs). DESIGN: Retrospective study. SUBJECTS: All patients who underwent surgery for LGG between 2010-15 at our centre. METHODS: Retrospective review. RESULTS: 91 out of 137 patients received AEDs preoperatively;70 due to initial presentation and 21 prophylactically.20/137 patients (14.6%) had seizures in the immediate postoperative period (14 days).Incidence of seizures in the immediate postoperative period was significantly lower in patients established on AEDs compared to the ones who received AEDs as prophylaxis or did not receive AED at all (10.0 vs 28.57 vs 15.22%, p = 0.10), but this difference became insignificant in the follow up period of 1 year (p = 0.69). 35 craniotomies were performed awake; seizures in the immediate postoperative period were more frequent in awake surgery but this was not significant (20 vs 12.75%, p = 0.29). The extent of resection, demonstrated an inverse trend on seizures at 1 year; only 3.3% of the patients who underwent total resection suffering seizures vs 12.5% of near total and 19.51% subtotal debulking or biopsy (p = 0.09). CONCLUSIONS: Patients established on regular AEDs tend to have fewer seizures in the immediate post operative period, but this difference becomes insignificant at 1 year. Awake craniotomy has no significant impact in the immediate and long term seizure activity. The extent of resection is a valid prognostic predictor of seizure activity.