Predictors of early postoperative epileptic seizures after awake surgery in supratentorial diffuse gliomas. 2020

Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
1Department of Neurosurgery, Sainte-Anne Hospital, Paris.

Functional-based resection under awake conditions had been associated with a nonnegligible rate of intraoperative and postoperative epileptic seizures. The authors assessed the incidence of intraoperative and early postoperative epileptic seizures after functional-based resection under awake conditions. The authors prospectively assessed intraoperative and postoperative seizures (within 1 month) together with clinical, imaging, surgical, histopathological, and follow-up data for 202 consecutive diffuse glioma adult patients who underwent a functional-based resection under awake conditions. Intraoperative seizures occurred in 3.5% of patients during cortical stimulation; all resolved without any procedure being discontinued. No predictor of intraoperative seizures was identified. Early postoperative seizures occurred in 7.9% of patients at a mean of 5.1 ± 2.9 days. They increased the duration of hospital stay (p = 0.018), did not impact the 6-month (median 95 vs 100, p = 0.740) or the 2-year (median 100 vs 100, p = 0.243) postoperative Karnofsky Performance Status score and did not impact the 6-month (100% vs 91.4%, p = 0.252) or the 2-year (91.7 vs 89.4%, p = 0.857) postoperative seizure control. The time to treatment of at least 3 months (adjusted OR [aOR] 4.76 [95% CI 1.38-16.36], p = 0.013), frontal lobe involvement (aOR 4.88 [95% CI 1.25-19.03], p = 0.023), current intensity for intraoperative mapping of at least 3 mA (aOR 4.11 [95% CI 1.17-14.49], p = 0.028), and supratotal resection (aOR 6.24 [95% CI 1.43-27.29], p = 0.015) were independently associated with early postoperative seizures. Functional-based resection under awake conditions can be safely performed with a very low rate of intraoperative and early postoperative seizures and good 6-month and 2-year postoperative seizure outcomes. Intraoperatively, the use of the lowest current threshold producing reproducible responses is mandatory to reduce seizure occurrence intraoperatively and in the early postoperative period.

UI MeSH Term Description Entries
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D007902 Length of Stay The period of confinement of a patient to a hospital or other health facility. Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D004558 Electric Stimulation Use of electric potential or currents to elicit biological responses. Stimulation, Electric,Electrical Stimulation,Electric Stimulations,Electrical Stimulations,Stimulation, Electrical,Stimulations, Electric,Stimulations, Electrical
D005260 Female Females
D005910 Glioma Benign and malignant central nervous system neoplasms derived from glial cells (i.e., astrocytes, oligodendrocytes, and ependymocytes). Astrocytes may give rise to astrocytomas (ASTROCYTOMA) or glioblastoma multiforme (see GLIOBLASTOMA). Oligodendrocytes give rise to oligodendrogliomas (OLIGODENDROGLIOMA) and ependymocytes may undergo transformation to become EPENDYMOMA; CHOROID PLEXUS NEOPLASMS; or colloid cysts of the third ventricle. (From Escourolle et al., Manual of Basic Neuropathology, 2nd ed, p21) Glial Cell Tumors,Malignant Glioma,Mixed Glioma,Glial Cell Tumor,Glioma, Malignant,Glioma, Mixed,Gliomas,Gliomas, Malignant,Gliomas, Mixed,Malignant Gliomas,Mixed Gliomas,Tumor, Glial Cell,Tumors, Glial Cell

Related Publications

Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
March 2001, Neurology India,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
August 2004, Der Nervenarzt,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
February 2014, Brain : a journal of neurology,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
June 2015, Journal of neurosurgery,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
January 1971, Neuropsihijatrija,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
April 1997, Neurosurgery,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
July 1996, Neurosurgery,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
December 1996, Neurosurgery,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
January 1983, Annales Universitatis Mariae Curie-Sklodowska. Sectio D: Medicina,
Marc Zanello, and Alexandre Roux, and Gilles Zah-Bi, and Bénédicte Trancart, and Eduardo Parraga, and Myriam Edjlali, and Arnault Tauziede-Espariat, and Xavier Sauvageon, and Tarek Sharshar, and Catherine Oppenheim, and Pascale Varlet, and Edouard Dezamis, and Johan Pallud
October 1990, Journal of neurosurgery,
Copied contents to your clipboard!