Abstract
Objective:Seizure is commonly found in patients with glioma. This study aimed to find risk factors for seizures in Indonesian patients with glioma. We also sought to determine the association between seizure and survival in this patient population. Methods:Patients with glioma were enrolled from the Dr. Sardjito General Hospital and other hospitals in Yogyakarta Province, Indonesia. Detailed demographic and clinical data were collected from medical records. DNA extraction and polymerase chain reaction (PCR) were performed to detect IDH1 mutation. Tumor tissue samples were stained by hematoxylin-eosin and classified according to the 2016 World Health Organization (WHO) classification of central nervous system (CNS) tumors. Expression of Ki-67 was detected by immunohistochemistry staining. Survival data were also collected. Results:In total, 107 patients were included in the analysis. Age, gender, history of smoking, tumor side, tumor grade, Ki-67 expression, and IDH1 mutation were not associated with seizure. Tumors involving the frontal lobe (p=0.037) and oligodendroglioma histology (p=0.031) were associated with the development of seizures in this study. However, multivariate analysis showed that only oligodendrogial histology was associated with seizure [p=0.032, odds ratio (OR) = 4.77, 95% confidence interval (CI) = 1.146-19.822]. Patients with seizures have significantly longer median overall survival than patients without seizures (69.3±25.01 vs. 10.6±6.14 months, respectively, p=0.04). Conclusion:This study showed that seizure in patients with glioma in Indonesia is associated with frontal lobe location and oligodendroglioma histology. Patients with seizures also have significantly longer overall survival.
Highlights
Seizure is commonly found in patients with brain tumors
This study showed that seizure in patients with glioma in Indonesia is associated with frontal lobe location and oligodendroglioma histology
Our study showed that factors associated with seizure in glioma patients were frontal lobe location and oligodendroglial histology
Summary
Seizure is commonly found in patients with brain tumors. Hughlings Jackson first described glioma-related seizures in 1882 (Samudra et al, 2019). Seizure can affect the patient’s quality of life due to morbidities and deterioration in cognitive function (Englot et al, 2012). The prevalence of seizures in patients with brain tumors ranges from 30% to 100%, depending on the tumor type. The most common brain tumors that develop seizures are neuroglial tumors and gliomas (Van Breemen et al, 2007). Previous studies showed that 30% to 50% of patients with brain tumors would develop seizure as their first clinical sign, whereas 10% to 30% of the patients will experience seizure later during the disease course (Van Breemen et al, 2007)
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