Choosing the tumoral epilepsy surgery candidate

Details

Serval ID
serval:BIB_A6F757B8BE9F
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Choosing the tumoral epilepsy surgery candidate
Journal
Epilepsia
Author(s)
Rheims S., Ducray F., Ryvlin P.
ISSN
1528-1167 (Electronic)
ISSN-L
0013-9580
Publication state
Published
Issued date
12/2013
Volume
54 Suppl 9
Pages
91-6
Language
english
Notes
Rheims, Sylvain
Ducray, Francois
Ryvlin, Philippe
eng
Review
Epilepsia. 2013 Dec;54 Suppl 9:91-6. doi: 10.1111/epi.12451.
Abstract
The management of epilepsy is an essential clinical issue in many patients with brain tumors. Tumoral epilepsy is often drug resistant and is associated with poor quality of life. Surgery represents a key therapeutic option in the management of patients with refractory tumoral epilepsy, with high rates of postoperative seizure freedom, especially when gross total resection can be performed. The selection of surgical candidates first requires extrapolation of the presumed underlying pathology and its potential for malignant transformation from clinical and imaging data, especially MRI characteristics. These data determine the decision for surgery, as well as its timing and technical aspects in relation to the risk of postoperative deficit. In glioneuronal tumors, where seizures are often drug-resistant and risk of malignant transformation is very low, epilepsy surgery is usually recommended to alleviate disabling seizures and side effects of antiepileptic drugs. However, the risk of postoperative deficit may outweigh potential benefits of surgery in tumors located within eloquent cortex. This issue is particularly relevant for glioneuronal tumors located within the dominant mesial temporal structures in patients in whom seizure control might require additional hippocampectomy, associated with a high risk of memory decline. In contrast, in patients with low-grade gliomas or aggressive brain neoplasms, both the decision to perform surgery and selection of the best surgical approach primarily rely on the oncologic imperative rather than epileptologic considerations. In these patients, the extent of tumor resection correlates with improved survival, progression-free survival, as well as with the chances of postoperative seizure control.
Keywords
Brain Neoplasms/classification/complications/surgery, Diagnosis, Differential, Epilepsy/etiology/*surgery, Humans, Neurosurgical Procedures/*methods, *Patient Selection, Brain tumors, Epilepsy, Epilepsy surgery, Glioma, Glioneuronal tumor
Pubmed
Open Access
Yes
Create date
29/11/2018 12:37
Last modification date
20/08/2019 15:11
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