Please use this identifier to cite or link to this item: http://dspace.sctimst.ac.in/jspui/handle/123456789/2710
Title: Surgery for "Long-term epilepsy associated tumors (LEATs)": Seizure outcome and its predictors
Authors: Radhakrishnan, A
Abraham, M
Vilanilam, G
Menon, R
Menon, D
Kumar, H
Cherian, A
Radhakrishnan, N
Kesavadas, C
Thomas, B
Sarma, SP
Thomas, SV
Keywords: LEATs Seizure outcome Resective surgery
Issue Date: Feb-2016
Publisher: Clin Neurol Neurosurg
Citation: Radhakrishnan A, Abraham M, Vilanilam G, Menon R, Menon D, Kumar H, Cherian A, Radhakrishnan N, Kesavadas C, Thomas B, Sarma SP, Thomas SV. Surgery for "Long-term epilepsy associated tumors (LEATs)": Seizure outcome and its predictors. Clin Neurol Neurosurg. 2016;141:98-105
Abstract: Objectives: “Long-term epilepsy associated tumors (LEATs)” by definition are tumors primarily causing drug-resistant seizures for two years or more. They include low-grade glial and glioneuronal tumors with normal life expectancy. We studied a large cohort of patients with LEATs who underwent surgery through our epilepsy program. Patients & methods: From 1998–2011, 105 patients with LEATs underwent surgery in our center. We utilized their data archived in a prospective registry to evaluate their electro-clinical-imaging characteristics affecting the long-term seizure outcome. Results: Of 105patients (age 3–50 years),meanage at surgery was 20 years andmeanpre-surgicalduration of epilepsy was 10.9 years. 66 (62.8%) had secondary generalized seizures. 82 had temporal tumors, 23 had extra temporal (13 frontal, 3 parietal, 2 occipital and 5 multilobar lesions) and four had associated hippocampal sclerosis. The interictal discharges and ictal onset were concordant to the lesion in 82 (78%) and 98 (93%) patients respectively. Lesionectomy and/or adjoining corticectomy or temporal lobectomy was done. Ganglioglioma was the most dominant pathological substrate in 61 (58%). During a mean follow-up of 7.5 years (range 3–16 years), 78/105 (74.2%) were seizure-free and 45 (57.4%) were totally off drugs. Secondary generalized seizures (p-0.02), temporal location of tumor (p-0.008) and spikes in third month post-operative EEG (p-0.03) caused unfavorable seizure outcome. A pre-surgical duration of epilepsy of more than 6.6 years caused less than optimal surgical outcome Conclusions: Early surgery should be considered a priority in LEATs. Presence of secondary generalized seizures is the single most important predictor of a poor seizure outcome
URI: http://dx.doi.org/10.1016/j.clineuro.2015.12.020
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