Clinical characteristics and surgical outcomes of low-grade epilepsy-associated brain tumors

Suhui Kuang ¹, Shaohui Zhang ^2,3, Zhiqiang Cui ³

⁰Functional Neurosurgery Department, National Children's Health Center of China, Beijing Children's Hospital, Capital Medical University, Beijing, China.

Therapeutic Advances in Neurological Disorders +

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March 25, 2024

View abstract on PubMed

Summary

Complete resection and negative electroencephalography (EEG) are key to seizure freedom after low-grade epilepsy-associated brain tumor (LEAT) surgery. Poor seizure outcomes are linked to partial resection and persistent epileptiform discharges. This study identifies critical factors for improving LEAT treatment success.

Area Of Science

Neurosurgery
Epileptology
Neuropathology

Background

Low-grade epilepsy-associated brain tumors (LEATs) are a common cause of epilepsy, with a low malignant potential.
Treatment for LEATs prioritizes seizure control over oncological outcomes due to good overall survival rates.

Purpose Of The Study

To identify risk factors influencing seizure outcomes in patients with LEATs following resective surgery.
To evaluate the effectiveness of various surgical and diagnostic parameters in predicting seizure control.

Main Methods

Retrospective analysis of 111 patients with LEATs undergoing resective surgery across three epilepsy centers.
Assessment of demographic, clinical, neurophysiological, and neuropathological data.
Application of Synthetic Minority Oversampling Technique (SMOTE) and Gaussian Naïve Bayes (GNB) algorithms for outcome prediction.

Main Results

Seizure freedom rates were 91.0% at 1 year, 87.5% at 2 years, and 79.1% at 5 years.
Partial resection, positive intraoperative electrocorticography (ECoG), and postoperative scalp electroencephalography (EEG) were associated with poorer seizure outcomes.
The GNB-SMOTE model demonstrated high predictive accuracy for seizure outcomes at 1, 2, and 5 years.

Conclusions

Partial resection and persistent epileptiform discharges (indicated by ECoG/EEG) are significant predictors of poor seizure outcomes.
Intraoperative ECoG is valuable for optimizing seizure control strategies.
A multivariate correlation analysis model based on GNB effectively predicts seizure outcomes in LEAT patients.

Keywords:

electroencephalography epilepsy epileptic surgery low-grade epilepsy-associated brain tumor seizure control

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