Manuel Toledo1, Silvana Sarria-Estrada2, Manuel Quintana3, Xavier Maldonado4, Francisco Martinez-Ricarte5, Jordi Rodon6, Cristina Auger2, Javier Salas-Puig3, Estevo Santamarina3, Elena Martinez-Saez7. 1. Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. Electronic address: mtoledo@vhebron.net. 2. MR Unit, Radiology Department, Institut Diagnostic per la Imatge, Vall d'Hebron University Hospital, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. 3. Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. 4. Oncologic Radiotherapy Department, Vall d'Hebron University Hospital, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. 5. Neurosurgery Department, Vall d'Hebron University Hospital, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. 6. Vall d'Hebron Institut of Oncology, Vall d'Hebron University Hospital, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. 7. Neuropathology Unit, Pathology Department, Vall d́Hebron University Hospital, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
Abstract
OBJECTIVES: The role of seizures and antiepileptic treatments associated with glioblastoma is a current topic of discussion. The objective of this study is to characterize and establish implications of epilepsy associated with glioblastoma. PATIENTS AND METHODS: We retrospectively analyzed the medical history, focused on epileptic features of 134 histologically diagnosed glioblastoma over a period of 4 years. RESULTS: The sample group had an average age of 56 years and 66% were male. Complete tumor resection was performed in 66% and 64.2% received further radio-oncologic treatment. The average survival rate was 12.4 months and 11.5% survived to 5 years. Epileptic seizures were the presentation symptom in 27% of cases and 51% suffered seizures during the disease, 26% become drug-resistant. Focal evolving to a bilateral convulsive seizures were the most frequent type. Epileptic seizures at presentation independently predicted longer survival (p<0.001). Furthermore, a history of epilepsy or seizures during disease improved survival. Late onset seizures, recurrences or status epilepticus during the course of the disease indicated tumor progression or the final stages of life. Prophylactic antiepileptic drugs did not prevent seizures. Similarly, there was no difference in survival between patients who did not use antiepileptic drugs and those using valproate or levetiracetam. Patients under 60 years, full oncologic treatment and secondary glioblastomas were factors that improved survival (p<0.001). CONCLUSION: Previous history of epilepsy or the onset of seizures as a presentation symptom in glioblastomas predict longer survival. Half of patients have seizures during the course of the disease. Antiepileptic drugs alone do not increase survival in glioblastoma patients.
OBJECTIVES: The role of seizures and antiepileptic treatments associated with glioblastoma is a current topic of discussion. The objective of this study is to characterize and establish implications of epilepsy associated with glioblastoma. PATIENTS AND METHODS: We retrospectively analyzed the medical history, focused on epileptic features of 134 histologically diagnosed glioblastoma over a period of 4 years. RESULTS: The sample group had an average age of 56 years and 66% were male. Complete tumor resection was performed in 66% and 64.2% received further radio-oncologic treatment. The average survival rate was 12.4 months and 11.5% survived to 5 years. Epilepticseizures were the presentation symptom in 27% of cases and 51% suffered seizures during the disease, 26% become drug-resistant. Focal evolving to a bilateral convulsive seizures were the most frequent type. Epilepticseizures at presentation independently predicted longer survival (p<0.001). Furthermore, a history of epilepsy or seizures during disease improved survival. Late onset seizures, recurrences or status epilepticus during the course of the disease indicated tumor progression or the final stages of life. Prophylactic antiepileptic drugs did not prevent seizures. Similarly, there was no difference in survival between patients who did not use antiepileptic drugs and those using valproate or levetiracetam. Patients under 60 years, full oncologic treatment and secondary glioblastomas were factors that improved survival (p<0.001). CONCLUSION: Previous history of epilepsy or the onset of seizures as a presentation symptom in glioblastomas predict longer survival. Half of patients have seizures during the course of the disease. Antiepileptic drugs alone do not increase survival in glioblastomapatients.
Authors: Patrick M Flanigan; Arman Jahangiri; Ruby Kuang; Albert Truong; Sarah Choi; Alvin Chou; Jonathan W Rick; Susan M Chang; Annette M Molinaro; Michael W McDermott; Mitchel S Berger; Manish K Aghi Journal: Neurosurgery Date: 2017-11-01 Impact factor: 4.654
Authors: Jia-Shu Chen; Ross Clarke; Alexander F Haddad; Elaina J Wang; Michel Lacroix; Indra Neil Sarkar; Ramin Zand; Elizabeth S Chen; Steven A Toms Journal: J Neurooncol Date: 2022-01-04 Impact factor: 4.130
Authors: Dayane B Koshiyama; Patrícia Trevisan; Carla Graziadio; Rafael F M Rosa; Bibiana Cunegatto; Juliete Scholl; Valentina O Provenzi; Alexandre P de Sá; Fabiano P Soares; Maíra C Velho; Nelson de A P Filho; Ceres A Oliveira; Paulo R G Zen Journal: J Neurooncol Date: 2017-08-30 Impact factor: 4.130
Authors: Kristin M Knudsen-Baas; Anders Engeland; Nils Erik Gilhus; Anette M Storstein; Jone F Owe Journal: J Neurooncol Date: 2016-07-04 Impact factor: 4.130