TY - JOUR
T1 - Epileptic seizures heralding a relapse in high grade gliomas
AU - Di Bonaventura, Carlo
AU - Albini, Mariarita
AU - D'Elia, Alessandro
AU - Fattouch, Jinane
AU - Fanella, Martina
AU - Morano, Alessandra
AU - Lucignani, Giulia
AU - Manfredi, Mario
AU - Colonnese, Claudio
AU - Salvati, Maurizio
AU - Vanacore, Nicola
AU - Berardelli, Alfredo
AU - Giallonardo, Anna Teresa
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Purpose Seizures are a common clinical symptom in high-grade gliomas (HGG). The aim of the study was to investigate the relationship between seizures and HGG relapse (HGG-R). Methods We retrospectively evaluated 145 patients who were surgically treated for HGG-R. By analyzing clinical characteristics in these patients (all operated and treated by the same protocol), we identified 37 patients with seizures during follow-up. This cohort was divided into four subgroups according to a) presence or absence of seizures at the time of diagnosis and b) temporal relationship between seizure occurrence and HGG-R during follow-up: subgroup A (25 pts) had seizures at follow-up but not at onset, subgroup B (12 pts) had seizures both at follow-up and onset, subgroup C (30 pts) had seizures before MRI-documented HGG-R, and subgroup D (7 pts) had seizures after MRI-documented HGG-R. Results Although the datum was not statistically significant, survival was longer in patients with seizures during follow-up than in those without seizures (59.3% vs 51.4% alive at 2 years). In 30 patients (subgroup C) seizures heralded HGG-R. In a correlation analysis for this last subgroup, the time interval between seizure and the HGG-R was significantly associated with the number of chemotherapy cycles (r = 0.470; p = 0.009) and follow-up duration (r = 0.566; p = 0.001). A linear regression model demonstrated a reciprocal association between the above factors and that it may be possible to estimate the timing of HGG-R by combining these data. Conclusions Seizures may herald HGG-R before MRI detection of relapse, thus suggesting that seizures should always be considered a red flag during follow-up.
AB - Purpose Seizures are a common clinical symptom in high-grade gliomas (HGG). The aim of the study was to investigate the relationship between seizures and HGG relapse (HGG-R). Methods We retrospectively evaluated 145 patients who were surgically treated for HGG-R. By analyzing clinical characteristics in these patients (all operated and treated by the same protocol), we identified 37 patients with seizures during follow-up. This cohort was divided into four subgroups according to a) presence or absence of seizures at the time of diagnosis and b) temporal relationship between seizure occurrence and HGG-R during follow-up: subgroup A (25 pts) had seizures at follow-up but not at onset, subgroup B (12 pts) had seizures both at follow-up and onset, subgroup C (30 pts) had seizures before MRI-documented HGG-R, and subgroup D (7 pts) had seizures after MRI-documented HGG-R. Results Although the datum was not statistically significant, survival was longer in patients with seizures during follow-up than in those without seizures (59.3% vs 51.4% alive at 2 years). In 30 patients (subgroup C) seizures heralded HGG-R. In a correlation analysis for this last subgroup, the time interval between seizure and the HGG-R was significantly associated with the number of chemotherapy cycles (r = 0.470; p = 0.009) and follow-up duration (r = 0.566; p = 0.001). A linear regression model demonstrated a reciprocal association between the above factors and that it may be possible to estimate the timing of HGG-R by combining these data. Conclusions Seizures may herald HGG-R before MRI detection of relapse, thus suggesting that seizures should always be considered a red flag during follow-up.
KW - Epilepsy
KW - High grade glioma
KW - Relapse
KW - Seizures
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U2 - 10.1016/j.seizure.2017.08.009
DO - 10.1016/j.seizure.2017.08.009
M3 - Article
AN - SCOPUS:85028623853
VL - 51
SP - 157
EP - 162
JO - Seizure : the journal of the British Epilepsy Association
JF - Seizure : the journal of the British Epilepsy Association
SN - 1059-1311
ER -