Intraoperative Seizures in Glioma Surgery: Is It Really Only an Intraoperative Issue?

Area of Science:

• Neurosurgery
• Epileptology
• Oncology

Background:

• Intraoperative seizures (IOS) are a known complication during surgery for diffuse low-grade gliomas (DLGGs).
• The incidence of IOS is higher in specific surgical contexts, including awake craniotomy, patients with a history of tumor-related epilepsy (TRE), and those undergoing cortical mapping.
• Understanding the factors contributing to IOS is essential for improving surgical safety and patient outcomes.

Purpose of the Study:

• To investigate the incidence and characteristics of intraoperative seizures (IOS) during diffuse low-grade glioma (DLGG) surgery.
• To identify risk factors associated with IOS in this patient population.
• To explore potential management strategies for IOS during DLGG resection.

Main Methods:

• Retrospective analysis of a cohort of patients undergoing DLGG surgery.
• Review of surgical records, including anesthetic management, electroencephalography (EEG) monitoring, and intraoperative events.
• Statistical analysis to identify predictors of IOS.

Main Results:

• IOS occurred in a significant proportion of DLGG surgeries, particularly in awake procedures.
• History of tumor-related epilepsy (TRE) and the need for cortical mapping were strongly associated with increased IOS risk.
• Specific anesthetic agents and surgical techniques may influence IOS occurrence.

Conclusions:

• Intraoperative seizures (IOS) are a critical consideration in diffuse low-grade glioma (DLGG) surgery.
• Proactive management and risk factor awareness are necessary for patients undergoing awake craniotomy or with pre-existing epilepsy.
• Further research into preventative measures and optimized anesthetic protocols for DLGG surgery is warranted.