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Abstract Details

Glioma-Related Seizures: Beyond Glioma Grade and Histopathology
Epilepsy/Clinical Neurophysiology (EEG)
S3 - Epilepsy/Clinical Neurophysiology (EEG) I (1:11 PM-1:22 PM)
002

Gliomas are commonly associated with the development of seizures, and in some cases the two conditions share common pathogenic mechanisms.


To examine the occurrence of glioma-related preoperative seizures (GPS) and post-operative seizure freedom (PSF) with respect to patient and glioma characteristics.

A prospective-cohort study of patients with glioma evaluated at the Mayo Clinic, Florida between 2016 to 2018. Clinical data including presence of GPS, EEG, characteristics of glioma, and PSF were assessed.

 

 

68 patients (mean age= 51-years, 45-males) were enrolled. 46 patients had GPS: 52% with only focal seizures while 48% also had focal to bilateral tonic-clonic seizures. Gliomas were located in the frontal (n=29), temporal (n=19), parietal (n=14), occipital lobe (n=3), and insula (n=3). 32 patients had pre-operative scalp EEGs: epileptiform activity (EA) in only two. 57 patients underwent intra-operative electrocorticography during awake craniotomy-assisted glioma resection: EA in 36, with intraoperative seizures seen in 7. 53 underwent gross-total resection: pilocytic astrocytoma (n=2), diffuse astrocytoma (n=4), oligodendroglioma (n=15), anaplastic astrocytoma (n=16), and glioblastoma (n=31). IDH1 mutations were seen in 32/68, MGMT methylation in 15/36, 1p/19q co-deletion in 15/21, over, and expression of p53 in 19/57. IDH2 mutation status was unknown for the majority. 31(67%) patients had PSF (mean follow-up=9 months). Patients with IDH1 mutation were likely to have GPS (p=0.037) and PSF (p=0.038). Patient without MGMT methylation (p=0.031) were also likely to have PSF. For the glioblastoma subtype, those without MGMT methylation were likely to have GPS (p=0.032). PSF or GPS did not differ by age, sex, glioma location/grade/histopathological subtype, or other tumor molecular markers (TMMs).

 

 

GPS may be more associated with TMMs (IDH1/MGMT) than glioma grade or histopathology. This association, however, may vary by histopathological subtype. Studies are needed to clarify the mechanisms of GPS and glioma growth by TMM status to identify new treatment targets for both conditions.
Authors/Disclosures
Anteneh M. Feyissa, MD, MSc, FAAN (Mayo Clinic)
PRESENTER
Dr. Feyissa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurelis.
Gregory A. Worrell, MD (Mayo Clinic College of Medicine) Dr. Worrell has received stock or an ownership interest from NeuroOne Inc.. Dr. Worrell has received stock or an ownership interest from Cadence Neuroscience Inc. The institution of Dr. Worrell has received research support from NIH. The institution of Dr. Worrell has received research support from Medtronic Inc.. The institution of Dr. Worrell has received research support from Neuropace Inc,. The institution of Dr. Worrell has received research support from Epilepsy Foundation of America. Dr. Worrell has received intellectual property interests from a discovery or technology relating to health care. Dr. Worrell has received intellectual property interests from a discovery or technology relating to health care.
William O. Tatum IV, DO, FAAN (Mayo Clinic) Dr. Tatum has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bioserenity. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Natus. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Tatum has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Defense Law Firm on behalf of a patient with epilepsy with funds donated to the Epilepsy Foundation of America. The institution of Dr. Tatum has received research support from Esai. The institution of Dr. Tatum has received research support from Mayo Clinic. The institution of Dr. Tatum has received research support from Liva Nova. The institution of Dr. Tatum has received research support from Engage Pharmaceuticals. The institution of Dr. Tatum has received research support from Xenon. Dr. Tatum has received intellectual property interests from a discovery or technology relating to health care. Dr. Tatum has received publishing royalties from a publication relating to health care. Dr. Tatum has received publishing royalties from a publication relating to health care. Dr. Tatum has received publishing royalties from a publication relating to health care. Dr. Tatum has a non-compensated relationship as a AAN Section Chair of Clinical Neurophysiology with AAN that is relevant to AAN interests or activities.
George K. Vilanilam, MBBS Dr. Vilanilam has nothing to disclose.
Nilufer Taner, MD, PhD, FAAN (Mayo Clinic) The institution of Dr. Taner has received research support from NIH.
Steven S. Rosenfeld, MD, PhD (The Neurological Institute of New York) No disclosure on file
No disclosure on file
No disclosure on file
Mariet Allen, PhD (Mayo Clinic) No disclosure on file
No disclosure on file
No disclosure on file
Alfredo Quinones-Hinojosa Alfredo Quinones-Hinojosa has nothing to disclose.