Relevant Analysis Of Surgical Schemes And Prognosis Of Secondary Epilepsy In Patients With Glioma

Purpose: To explore the relevant factors associated with the surgical schemes and prognosis of Secondary Epilepsy in patients with glioma.Method: The clinical cases of seizures in patients with glioma underwent neurosurgery in the First Affiliated Hospital of China Medical University were retrospectively collected from October 2011 to September 2018.A total of 134 cases were studied to analyze the relevant factors associated with the surgical schemes and prognosis.Datas on tumor locations,tumor size,seizure characteristics,seizure frequencies,duration of seizures,preoperative and postoperative MRI features,preoperative and postoperative use of antiepileptic drugs(AEDs),intraoperative electrocorticogram(ECo G)monitoring,intraoperative neuronavigation,post-operative pathological grading and post-operative Engel grading were collected.According to the surgical schemes,58 cases(43.28%)underwent simple tumor resection,23 cases(17.16%)underwent neuronavigation-assisted tumor resection,42 cases(31.34%)underwent ECo G monitoring-assisted tumor resection,and 11 cases(8.21%)underwent neuronavigation-assisted tumor resection.SPSS20.0 statistical software was used to analyze the collected datas.Results: During a follow-up period of 4 months to 7 years after surgery,58 cases were treated with simple tumor resection during operation,Engel class I to II were achieved in 19 patients and Engel class III to IV in 39 paients,the effective rate was 32.76%.23 cases were treated with neuronavigation-assisted tumor resection,Engel class I to II were achieved in 8 patients and Engel class III to IV in 15 patients,the effective rate was 34.78%.There were 42 cases underwent ECo G monitoring-assisted tumor resection,postoperative follow-up Engel class I to II in 29 patients,Engel class III-IV in 13 patients,the effective rate was 69.05%.11 cases were operated with ECo G monitoring combined with neuronavigation,postoperative follow-up Engel class I to II in 8 patients,Engel class III-IV in 3 patients,the effective rate was 69.05%.The preoperative epilepsy frequency and the use of intraoperative ECo G were correlated with the surgical efficacy and prognosis(P<0.05).But there were no statistically significant differences between the remission of epilepsy after operation and whether neuronavigation was applied during operation on the prognosis of glioma with epilepsy as complication(P > 0.05).Conclusions: Our results suggest that preoperative seizure frequency,location and grade of tumors and intraoperative ECo G monitoring are important factors for surgical efficacy and prognosis.Consequently,When glioma patients with epilepsy were treated with surgical operation,ECo G monitoring should be applied intraoperatively to define the scope of epilepsy lesions on the basis of resection of tumors as far as possible.