Epilepsy in Primary Cerebral Tumors: Long-Term Follow-Up of Seizures in the PERNO Study (Project of Emilia Romagna Region on Neuro-Oncology)

E. Pasini, E. Fallica, C. Monetti, S. Meletti, G. Monti, I. Florindo, R. Rizzi, R. Michelucci, The PERNO Study Group
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Abstract

Objective: Despite the high prevalence of epilepsy in brain tumors, long-term follow-up studies on tumoral epilepsy are lacking. Here we report the long-term follow-up results of the PERNO study (Project of Emilia-Romagna Region on Neuro-Oncology). Methods: PERNO study enrolled for a three-year period every person living in Emilia-Romagna Region with a new diagnosis of primary brain tumor (PBT). We previously described the short-term results of epilepsy evolution after the first surgical procedure in 100 patients; for 52 patients of this group, the long-term results of seizure outcome after a mean follow-up of 24 months are now available. Results: Out of these 52 patients, 41 presented with a high-grade glioma (HGG), whereas 11 had a low-grade glioma (LGG) at the onset of the disease (HGG/LGG ratio = 3.7) and were followed-up for a median period of 548 and 1032 days, respectively. The HGG group showed a seizure-freedom rate of more than 60%, with a better seizure control (up to 87%) being achieved in patients without evidence of tumor progression. Conversely, in the LGG group complete seizure control occurred only in one case (less than 10% of patients), with most patients requiring surgical revision due to the extension of the tumor. Conclusions: Our data show that epilepsy associated with HGG seems to have a relatively good outcome, especially if the tumor is stable. In contrast, seizure control in LGG was more difficult to be achieved, suggesting the need of detailed epileptological study (including long-term video-EEG monitoring) before surgery to improve seizure control.
原发性脑肿瘤的癫痫:PERNO研究中癫痫发作的长期随访(Emilia Romagna地区神经肿瘤学项目)
目的:脑肿瘤患者癫痫发生率高,但缺乏对肿瘤癫痫的长期随访研究。在此,我们报告了PERNO研究(Emilia-Romagna地区神经肿瘤学项目)的长期随访结果。方法:PERNO研究招募了生活在艾米利亚-罗马涅地区的每一位新诊断为原发性脑肿瘤(PBT)的患者,为期三年。我们之前描述了100例患者首次手术后癫痫发展的短期结果;对于该组中的52例患者,平均随访24个月后癫痫发作结果的长期结果现已可用。结果:在这52例患者中,41例在发病时表现为高级别胶质瘤(HGG),而11例在发病时表现为低级别胶质瘤(LGG) (HGG/LGG比值= 3.7),随访时间分别为548天和1032天。HGG组显示癫痫自由率超过60%,在没有肿瘤进展证据的患者中实现了更好的癫痫控制(高达87%)。相反,在LGG组中,只有1例(不到10%的患者)癫痫发作完全控制,大多数患者由于肿瘤的扩展需要手术翻修。结论:我们的数据显示癫痫与HGG相关似乎有一个相对较好的结果,特别是如果肿瘤是稳定的。相比之下,LGG的癫痫发作控制更难实现,提示术前需要详细的癫痫学研究(包括长期视频脑电图监测)以改善癫痫发作控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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