[Abstract] Predictors of early, recurrent and intractable seizures in low-grade glioma

Abstract

Purpose

Seizures are common among patients with low grade glioma (LGG) and can significantly impact morbidity. We sought to determine the association between the clinical and molecular factors with seizure incidence and refractoriness in LGG patients

Methods

We conducted a retrospective review at University of Virginia in patients with LGG (WHO Grade II) evaluated between 2002-2015. Descriptive statistics were calculated for variables of interest and the Kaplan-Meier method was used to estimate survival curves, which were compared with the log-rank test

Results

291 patients were included; 254 had molecular testing performed for presence of an IDH mutation and/or 1p/19q co-deletion. Sixty-eight percent of patients developed seizures prior to LGG diagnosis; 41% of all patients had intractable seizures. Utilizing WHO 2016 integrated classification, there was no significant difference in seizure frequency at pre- and post-operative periods or in developing intractable seizures, though a trend toward increased pre-operative seizure incidence among patients with IDH mutation was identified (p=0.09). Male gender was significantly associated with higher seizure incidence on pre-operative (p&0.001) and post-operative periods (p&0.001); men were also more likely to develop intractable seizures (p=0.01)

Conclusions

Seizures are common among patients with LGG. Differences in pre- or post-operative and intractable seizure rates by WHO 2016 classification were not detected. Our data showed a trend toward higher seizure incidence pre-operatively in patients with IDH mutant LGG. We describe a unique association between male gender and seizure incidence and intractability that warrants further studyTopic: 

Source: https://academic.oup.com/nop/advance-article-abstract/doi/10.1093/nop/npaa054/5899007