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SURG-38. SEIZUREOUTCOME AFTEREPILEPSY SURGERY INCHILDREN WITH BRAINTUMORS Ayat SiddiquiAmy McGregorJames W. Wheless2020 год

SURG-38. SEIZURE OUTCOME AFTER EPILEPSY SURGERY IN CHILDREN WITH BRAIN TUMORS
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Аннотация: Abstract INTRODUCTION Epilepsy is a common chronic neurological complication of childhood brain tumors and seizures are refractory to medical therapy in up to 10% of patients. Referral for a diagnostic evaluation is recommended in patients with seizures refractory to ≥2 anti-epileptic drugs (AED). Utility of epilepsy surgery is not established in children with brain tumors. OBJECTIVE Primary aim of this study was to determine seizure outcome after epilepsy surgery in children with childhood brain tumors. METHODS Institutional Review Board’s approval was obtained for this retrospective study. A diagnosis of childhood brain tumor and a referral to the epilepsy monitoring unit (EMU) were required to be included in this study. Seizure outcome was defined according to International League Against Epilepsy (ILAE) outcome scale. Pre and post-operative MRIs were reviewed. RESULTS Forty-two children were referred to the EMU from May 2004 to July 2019. Of the 10 patients that underwent epilepsy surgery, 7 (70%) had pre-surgery frequency of >10 seizures/month and 3(30%) of these had multiple daily seizures; the rest had 3-4 seizures/month. All were taking ≥3 AEDs. Median time from first seizure to surgery was 83.7 months (range 24.3-151.6). At a median follow-up of 67.5 months (range 4.9-133.5) after epilepsy surgery, 60% reported no seizures in the 6-months before the last follow-up. Three (30%) had ILAE class-1 outcome, 4 (40%) class-3, and 3 (30%) were class-4. One child was off AEDs and the others were on a single AED at last follow-up. No post-operative neurological or cognitive deficits were recognized. Focal cortical atrophy was present in 40% of children before and in 30% after surgery. CONCLUSION Epilepsy surgery improved seizure outcome in all children that had epilepsy surgery and reduced the number of AEDs needed to treat seizures. Children with brain tumors and intractable seizures should be referred for epilepsy surgery evaluation.
Год издания: 2020
Авторы: Ayat Siddiqui, Amy McGregor, James W. Wheless, Stephen P. Fulton, Sarah Weatherspoon, Paul Kilmo, Frederick A. Boop, Raja B. Khan
Издательство: Oxford University Press
Источник: Neuro-Oncology
Ключевые слова: Glioma Diagnosis and Treatment, Epilepsy research and treatment, Boron Compounds in Chemistry
Другие ссылки: Neuro-Oncology (PDF)
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Europe PMC (PubMed Central) (PDF)
Europe PMC (PubMed Central) (HTML)
PubMed Central (HTML)