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Early Epilepsy Surgery in Benign Cerebral Tumors: Avoid Your ‘Low-Grade’ Becoming a ‘Long-Term’ Epilepsy-Associated Tumor

Epilepsy surgery in low-grade epilepsy-associated neuroepithelial tumors (LEAT) is usually evaluated in drug-resistant cases, often meaning a time delay from diagnosis to surgery. To identify factors predicting good postoperative seizure control and neuropsychological outcome, the cohort of LEAT pat...

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Autores principales: Mann, Catrin, Conradi, Nadine, Neuhaus, Elisabeth, Konczalla, Jürgen, Freiman, Thomas M., Spyrantis, Andrea, Weber, Katharina, Harter, Patrick, Rosenow, Felix, Strzelczyk, Adam, Schubert-Bast, Susanne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571257/
https://www.ncbi.nlm.nih.gov/pubmed/36233759
http://dx.doi.org/10.3390/jcm11195892
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author Mann, Catrin
Conradi, Nadine
Neuhaus, Elisabeth
Konczalla, Jürgen
Freiman, Thomas M.
Spyrantis, Andrea
Weber, Katharina
Harter, Patrick
Rosenow, Felix
Strzelczyk, Adam
Schubert-Bast, Susanne
author_facet Mann, Catrin
Conradi, Nadine
Neuhaus, Elisabeth
Konczalla, Jürgen
Freiman, Thomas M.
Spyrantis, Andrea
Weber, Katharina
Harter, Patrick
Rosenow, Felix
Strzelczyk, Adam
Schubert-Bast, Susanne
author_sort Mann, Catrin
collection PubMed
description Epilepsy surgery in low-grade epilepsy-associated neuroepithelial tumors (LEAT) is usually evaluated in drug-resistant cases, often meaning a time delay from diagnosis to surgery. To identify factors predicting good postoperative seizure control and neuropsychological outcome, the cohort of LEAT patients treated with resective epilepsy surgery at the Epilepsy Center Frankfurt Rhine-Main, Germany between 2015 and 2020 was analyzed. Thirty-five patients (19 males (54.3%) and 16 females, aged 4 to 40 years (M = 18.1), mean follow-up 33 months) were included. Following surgery, 77.1% of patients remained seizure-free (Engel IA/ILAE 1). Hippocampus and amygdala resection was predictive for seizure freedom in temporal lobe epilepsy. In total, 65.7% of all patients showed cognitive deficits during presurgical workup, decreasing to 51.4% after surgery, predominantly due to significantly less impaired memory functions (p = 0.011). Patients with presurgical cognitive deficits showed a tendency toward a longer duration of epilepsy (p = 0.050). Focal to bilateral tonic-clonic seizures (p = 0.019) and young age at onset (p = 0.018) were associated with a higher likelihood of cognitive deficits after surgery. Therefore, we advocate early epilepsy surgery without requiring proof of drug-resistance. This refers especially to lesions associated with the non-eloquent cortex.
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spelling pubmed-95712572022-10-17 Early Epilepsy Surgery in Benign Cerebral Tumors: Avoid Your ‘Low-Grade’ Becoming a ‘Long-Term’ Epilepsy-Associated Tumor Mann, Catrin Conradi, Nadine Neuhaus, Elisabeth Konczalla, Jürgen Freiman, Thomas M. Spyrantis, Andrea Weber, Katharina Harter, Patrick Rosenow, Felix Strzelczyk, Adam Schubert-Bast, Susanne J Clin Med Article Epilepsy surgery in low-grade epilepsy-associated neuroepithelial tumors (LEAT) is usually evaluated in drug-resistant cases, often meaning a time delay from diagnosis to surgery. To identify factors predicting good postoperative seizure control and neuropsychological outcome, the cohort of LEAT patients treated with resective epilepsy surgery at the Epilepsy Center Frankfurt Rhine-Main, Germany between 2015 and 2020 was analyzed. Thirty-five patients (19 males (54.3%) and 16 females, aged 4 to 40 years (M = 18.1), mean follow-up 33 months) were included. Following surgery, 77.1% of patients remained seizure-free (Engel IA/ILAE 1). Hippocampus and amygdala resection was predictive for seizure freedom in temporal lobe epilepsy. In total, 65.7% of all patients showed cognitive deficits during presurgical workup, decreasing to 51.4% after surgery, predominantly due to significantly less impaired memory functions (p = 0.011). Patients with presurgical cognitive deficits showed a tendency toward a longer duration of epilepsy (p = 0.050). Focal to bilateral tonic-clonic seizures (p = 0.019) and young age at onset (p = 0.018) were associated with a higher likelihood of cognitive deficits after surgery. Therefore, we advocate early epilepsy surgery without requiring proof of drug-resistance. This refers especially to lesions associated with the non-eloquent cortex. MDPI 2022-10-05 /pmc/articles/PMC9571257/ /pubmed/36233759 http://dx.doi.org/10.3390/jcm11195892 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mann, Catrin
Conradi, Nadine
Neuhaus, Elisabeth
Konczalla, Jürgen
Freiman, Thomas M.
Spyrantis, Andrea
Weber, Katharina
Harter, Patrick
Rosenow, Felix
Strzelczyk, Adam
Schubert-Bast, Susanne
Early Epilepsy Surgery in Benign Cerebral Tumors: Avoid Your ‘Low-Grade’ Becoming a ‘Long-Term’ Epilepsy-Associated Tumor
title Early Epilepsy Surgery in Benign Cerebral Tumors: Avoid Your ‘Low-Grade’ Becoming a ‘Long-Term’ Epilepsy-Associated Tumor
title_full Early Epilepsy Surgery in Benign Cerebral Tumors: Avoid Your ‘Low-Grade’ Becoming a ‘Long-Term’ Epilepsy-Associated Tumor
title_fullStr Early Epilepsy Surgery in Benign Cerebral Tumors: Avoid Your ‘Low-Grade’ Becoming a ‘Long-Term’ Epilepsy-Associated Tumor
title_full_unstemmed Early Epilepsy Surgery in Benign Cerebral Tumors: Avoid Your ‘Low-Grade’ Becoming a ‘Long-Term’ Epilepsy-Associated Tumor
title_short Early Epilepsy Surgery in Benign Cerebral Tumors: Avoid Your ‘Low-Grade’ Becoming a ‘Long-Term’ Epilepsy-Associated Tumor
title_sort early epilepsy surgery in benign cerebral tumors: avoid your ‘low-grade’ becoming a ‘long-term’ epilepsy-associated tumor
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571257/
https://www.ncbi.nlm.nih.gov/pubmed/36233759
http://dx.doi.org/10.3390/jcm11195892
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