Original PaperPrevalence and prognostic significance of epilepsy in patients with gliomas
Introduction
Epileptic seizures are common in patients with primary brain tumours1, 2, 3, and those who present with seizures may have a better prognosis4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15. A prevalence of epilepsy in a larger series of high-grade gliomas ranging from 22 to 37% has been reported4, 5, 6. In previous reports of astrocytomas or low-grade gliomas, the prevalence of epilepsy has ranged from 50 to 78%7, 8, 9, 10, 11. An exceptionally high value of 90% in patients with astrocytoma was found in Piepmeier’s study[12]. Oligodendroglioma patients are generally thought to have the highest probability of epilepsy, with a prevalence of 72% in two recent series13, 14. However, most published papers reporting the prevalence and prognostic significance of epilepsy in patients with intracranial gliomas are fairly small2, 6, 8, 9, 10, 11, 12, report on selected patients4, 5, 9, 12, 14, 16, accrued before the computer tomography (CT) era2, 9, 13, 17, or include many patients with unknown histology7, 15. Such studies may not reliably describe the true prevalence and prognostic implications of epilepsy in patients with gliomas.
Therefore, we investigated the prevalence and prognostic implications of epilepsy in 1028 consecutive patients with intracranial gliomas of known histology accrued at a single regional centre during the CT era.
Section snippets
Patients and methods
Data from 1028 patients with histologically verified primary intracranial tumours seen at the Norwegian Radium Hospital between 1980 and 1995 were examined. Together with two regional neurosurgical departments, the hospital provides the only neuro-oncological service to a population of 1.6 million living in south-eastern Norway outside Oslo. Between 1980 and 1987, the hospital also provided radiotherapy for brain tumour patients from the five northernmost counties of Norway.
Hospital records were
Results
Median patient age and survival in each main histological subgroup are presented in Table 2. Only 61 patients were younger than 20 years, 20 had high-grade and 41 had low-grade tumours. A total of 190 patients, 170 with high-grade and 20 with low-grade tumours, were over 60 years of age. WHO performance status was 0–1 in 807 patients and 2–4 in 220 patients with histological intracranial glioma. Overall, 669 out of these 1028 patients (65.1%) experienced epileptic seizures during their
Discussion
The reported prevalence of epilepsy in patients with gliomas ranges from 30 to 90%4, 5, 6, 7, 8, 12, 13, 14, 15, 17, 22, 23, with low-grade glioma patients having the highest prevalence7, 8, 9, 11, 12, 22. In an unselected patient group containing high-grade aggressive tumours as well as indolent low-grade gliomas, epilepsy clearly can be expected to be a positive prognostic factor7, 16, 17, 23.
Our findings, based on a very large single institution regionally and consecutively accrued patient
Acknowledgements
Knut Lote was a Clinical Research Fellow for the Norwegian Cancer Society.
References (30)
- et al.
An outcome audit at the epilepsy clinic: results from 1000 consecutive referrals
Seizure
(1994) - et al.
National General Practice Study of Epilepsy: newly diagnosed epileptic seizures in a general population
Lancet
(1990) - et al.
Low-grade glioma of the cerebral hemispheres in adults: a retrospective analysis of 88 cases
Int J Radiat Oncol Biol Phys
(1990) - et al.
Late onset epileptic seizures
Acta Neurol Scand
(1985) - Walker MD, Green SB, Byar DP, et al. Randomized comparisons of radiotherapy and nitrosureas for the treatment of...
- Chang CH, Horton J, Schoenfeld D, et al. Comparison of postoperative radiotherapy and combined postoperative...
- et al.
Supratentorial anaplastic gliomas in adults
J Neurosurg
(1989) - et al.
The prognosis of primary intracerebral tumours presenting with epilepsy: the outcome of medical and surgical management
J Neurol Neurosurg Psychiatry
(1991) - et al.
Benign cerebral gliomas. Clinical and radiological characteristics
Ugeskr Laeger
(1993) - Janny P, Cure H, Mohr M, et al. Low grade supratentorial astrocytomas. Cancer 1994, 73,...
Supratentorial low-grade glioma in adults: An analysis of prognostic factors and timing of radiation
J Clin Oncol
Observations on the current treatment of low-grade astrocytic tumors of the cerebral hemispheres
J Neurosurg
Oligodendrogliomas: the Mayo Clinic experience
J Neurosurg
Cerebral oligodendroglioma: Prognostic factors and life history
Neurosurgery
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