Predictors of early postoperative epileptic seizures after awake surgery in supratentorial diffuse gliomas
| العنوان: | Predictors of early postoperative epileptic seizures after awake surgery in supratentorial diffuse gliomas |
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| المؤلفون: | Bénédicte Trancart, Pascale Varlet, Johan Pallud, Alexandre Roux, Arnault Tauziède-Espariat, Edouard Dezamis, Catherine Oppenheim, Myriam Edjlali, Eduardo Parraga, Xavier Sauvageon, Marc Zanello, Tarek Sharshar, Gilles Zah-Bi |
| المساهمون: | Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Sorbonne Paris Cité (USPC), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Neuropathologie expérimentale / Experimental neuropathology, Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Martinez Rico, Clara, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Institut Pasteur [Paris]-Université de Paris (UP) |
| المصدر: | Journal of Neurosurgery Journal of Neurosurgery, 2020, 134 (3), pp.683-692. ⟨10.3171/2020.1.jns192774⟩ Journal of Neurosurgery, American Association of Neurological Surgeons, 2020, 134 (3), pp.683-692. ⟨10.3171/2020.1.jns192774⟩ |
| بيانات النشر: | HAL CCSD, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Male, Adolescent, Time to treatment, Neurosurgical Procedures, 03 medical and health sciences, Epilepsy, Young Adult, 0302 clinical medicine, Postoperative Complications, epileptic seizure, Predictive Value of Tests, Seizures, Glioma, glioma, Seizure control, medicine, Humans, postoperative, Prospective Studies, Karnofsky Performance Status, Wakefulness, Awake surgery, Intraoperative Complications, Aged, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Incidence (epidemiology), Supratentorial Neoplasms, General Medicine, Length of Stay, Middle Aged, medicine.disease, Electric Stimulation, awake surgery, Treatment Outcome, Frontal lobe, 030220 oncology & carcinogenesis, Anesthesia, oncology, epilepsy, Female, intraoperative, Epileptic seizure, medicine.symptom, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | OBJECTIVEFunctional-based resection under awake conditions had been associated with a nonnegligible rate of intraoperative and postoperative epileptic seizures. The authors assessed the incidence of intraoperative and early postoperative epileptic seizures after functional-based resection under awake conditions.METHODSThe authors prospectively assessed intraoperative and postoperative seizures (within 1 month) together with clinical, imaging, surgical, histopathological, and follow-up data for 202 consecutive diffuse glioma adult patients who underwent a functional-based resection under awake conditions.RESULTSIntraoperative seizures occurred in 3.5% of patients during cortical stimulation; all resolved without any procedure being discontinued. No predictor of intraoperative seizures was identified. Early postoperative seizures occurred in 7.9% of patients at a mean of 5.1 ± 2.9 days. They increased the duration of hospital stay (p = 0.018), did not impact the 6-month (median 95 vs 100, p = 0.740) or the 2-year (median 100 vs 100, p = 0.243) postoperative Karnofsky Performance Status score and did not impact the 6-month (100% vs 91.4%, p = 0.252) or the 2-year (91.7 vs 89.4%, p = 0.857) postoperative seizure control. The time to treatment of at least 3 months (adjusted OR [aOR] 4.76 [95% CI 1.38–16.36], p = 0.013), frontal lobe involvement (aOR 4.88 [95% CI 1.25–19.03], p = 0.023), current intensity for intraoperative mapping of at least 3 mA (aOR 4.11 [95% CI 1.17–14.49], p = 0.028), and supratotal resection (aOR 6.24 [95% CI 1.43–27.29], p = 0.015) were independently associated with early postoperative seizures.CONCLUSIONSFunctional-based resection under awake conditions can be safely performed with a very low rate of intraoperative and early postoperative seizures and good 6-month and 2-year postoperative seizure outcomes. Intraoperatively, the use of the lowest current threshold producing reproducible responses is mandatory to reduce seizure occurrence intraoperatively and in the early postoperative period. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0022-3085 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::148423f4a3bf85a5d057a58c7c5037fa https://www.hal.inserm.fr/inserm-03279611 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....148423f4a3bf85a5d057a58c7c5037fa |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00223085 |
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