scholarly journals Tumour - Related Epilepsy and Post-Surgical Outcome: Tertiary Hospital Experience in Saudi Arabia

2020 ◽  
Author(s):  
Alawi Aqel Aqel Abdullah Alattas ◽  
Hindi Al-Hindi ◽  
Tariq AbaAlkhail ◽  
Amen Bawazir ◽  
Hesham Aldhalaan ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Epilepsy Surgery ◽  
Tertiary Hospital ◽  
First Year ◽  
Seizure Outcome ◽  
Low Grade ◽  
Presurgical Evaluation ◽  
Tumor Pathology ◽  
Class 1 ◽  
One Year

Abstract Background Some studies have suggested that tumor pathology significantly influence freedom from seizures post epilepsy surgery; however, there is no consensus among researchers regarding this issue. This study aims to retrospectively look for different types of tumor- related epilepsy and their outcomes in the first-year post epilepsy surgery among both adults and children. Methods In this hospital-based retrospective study, patients with drug resistant epilepsy due to brain tumor who underwent epilepsy surgery were included. Our patients underwent a thorough presurgical evaluation in an Epilepsy Monitoring Unit (EMU) before deciding to undergo surgical intervention, according to an epilepsy case-management conference. Four outcomes of interest were investigated during the first-year post epilepsy surgery.Results One hundred patients with brain tumors were included in this study (male: female = 3:2); 45 patients were children. Most of the patients (93) had low-grade gliomas or glioneuronal tumors (G/GNT). No significant differences in outcome were observed between sex, age, or histopathological categories. However, during the first year after epilepsy surgery most of the low-grade G/GNT cases showed favorable outcomes of International League Against Epilepsy (ILAE) class 1 and 2 (61.3% and 9.7%, respectively), while high-grade gliomas and meningothelial tumors showed outcomes of ILAE class 1 (40% and 100%, respectively). Conclusions One-year favorable outcome of post epilepsy surgery of different brain tumors have been achieved among both children and adults. Adequate presurgical evaluation in EMU (for long-term video-electroencephalography monitoring) to plan appropriate surgical strategy is advised. Tumor Pathology does not influence seizure outcome one-year post epilepsy surgery.

scholarly journals Reoperation after failed resective epilepsy surgery in children

2017 ◽  
Vol 20 (2) ◽  
pp. 134-140 ◽  
Author(s):  
Osama Muthaffar ◽  
Klajdi Puka ◽  
Luc Rubinger ◽  
Cristina Go ◽  
O. Carter Snead ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Pediatric Population ◽  
Seizure Outcome ◽  
Incomplete Resection ◽  
Epileptogenic Zone ◽  
Effective Treatment Option ◽  
Second Surgery ◽  
Class 1 ◽  
One Year ◽  
International League

OBJECTIVEAlthough epilepsy surgery is an effective treatment option, at least 20%–40% of patients can continue to experience uncontrolled seizures resulting from incomplete resection of the lesion, epileptogenic zone, or secondary epileptogenesis. Reoperation could eliminate or improve seizures. Authors of this study evaluated outcomes following reoperation in a pediatric population.METHODSA retrospective single-center analysis of all patients who had undergone resective epilepsy surgery in the period from 2001 to 2013 was performed. After excluding children who had repeat hemispherotomy, there were 24 children who had undergone a second surgery and 2 children who had undergone a third surgery. All patients underwent MRI and video electroencephalography (VEEG) and 21 underwent magnetoencephalography (MEG) prior to reoperation.RESULTSThe mean age at the first and second surgery was 7.66 (SD 4.11) and 10.67 (SD 4.02) years, respectively. The time between operations ranged from 0.03 to 9 years. At reoperation, 8 patients underwent extended cortical resection; 8, lobectomy; 5, lesionectomy; and 3, functional hemispherotomy. One year after reoperation, 58% of the children were completely seizure free (International League Against Epilepsy [ILAE] Class 1) and 75% had a reduction in seizures (ILAE Classes 1–4). Patients with MEG clustered dipoles were more likely to be seizure free than to have persistent seizures (71% vs 40%, p = 0.08).CONCLUSIONSReoperation in children with recurrent seizures after the first epilepsy surgery could result in favorable seizure outcomes. Those with residual lesion after the first surgery should undergo complete resection of the lesion to improve seizure outcome. In addition to MRI and VEEG, MEG should be considered as part of the reevaluation prior to reoperation.

scholarly journals SURG-38. SEIZURE OUTCOME AFTER EPILEPSY SURGERY IN CHILDREN WITH BRAIN TUMORS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii211-ii211
Author(s):  
Ayat Siddiqui ◽  
Amy L McGregor ◽  
James W Wheless ◽  
Stephen P Fulton ◽  
Sarah E Weatherspoon ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Epilepsy Surgery ◽  
Neurological Complication ◽  
Cortical Atrophy ◽  
Seizure Outcome ◽  
Childhood Brain Tumors ◽  
Institutional Review ◽  
Intractable Seizures ◽  
Class 1

Abstract INTRODUCTION Epilepsy is a common chronic neurological complication of childhood brain tumors and seizures are refractory to medical therapy in up to 10% of patients. Referral for a diagnostic evaluation is recommended in patients with seizures refractory to ≥2 anti-epileptic drugs (AED). Utility of epilepsy surgery is not established in children with brain tumors. OBJECTIVE Primary aim of this study was to determine seizure outcome after epilepsy surgery in children with childhood brain tumors. METHODS Institutional Review Board’s approval was obtained for this retrospective study. A diagnosis of childhood brain tumor and a referral to the epilepsy monitoring unit (EMU) were required to be included in this study. Seizure outcome was defined according to International League Against Epilepsy (ILAE) outcome scale. Pre and post-operative MRIs were reviewed. RESULTS Forty-two children were referred to the EMU from May 2004 to July 2019. Of the 10 patients that underwent epilepsy surgery, 7 (70%) had pre-surgery frequency of >10 seizures/month and 3(30%) of these had multiple daily seizures; the rest had 3-4 seizures/month. All were taking ≥3 AEDs. Median time from first seizure to surgery was 83.7 months (range 24.3-151.6). At a median follow-up of 67.5 months (range 4.9-133.5) after epilepsy surgery, 60% reported no seizures in the 6-months before the last follow-up. Three (30%) had ILAE class-1 outcome, 4 (40%) class-3, and 3 (30%) were class-4. One child was off AEDs and the others were on a single AED at last follow-up. No post-operative neurological or cognitive deficits were recognized. Focal cortical atrophy was present in 40% of children before and in 30% after surgery. CONCLUSION Epilepsy surgery improved seizure outcome in all children that had epilepsy surgery and reduced the number of AEDs needed to treat seizures. Children with brain tumors and intractable seizures should be referred for epilepsy surgery evaluation.

Multivariable prediction of seizure outcome one year after resective epilepsy surgery: development of a model with independent validation

1998 ◽  
Vol 29 (3) ◽  
pp. 185-194 ◽  
Author(s):  
Anne T Berg ◽  
Thaddeus Walczak ◽  
Lawrence J Hirsch ◽  
Susan S Spencer
Keyword(s):  
Epilepsy Surgery ◽  
Seizure Outcome ◽  
Independent Validation ◽  
One Year

scholarly journals Long-term seizure outcome and its predictors in patients with recurrent seizures during the first year aftertemporal lobe resective epilepsy surgery

Epilepsia ◽  
2011 ◽  
Vol 52 (5) ◽  
pp. 917-924 ◽  
Author(s):  
Kallakatta N. Ramesha ◽  
Tomin Mooney ◽  
P. Sankara Sarma ◽  
Kurupath Radhakrishnan
Keyword(s):  
Epilepsy Surgery ◽  
First Year ◽  
Seizure Outcome

scholarly journals Outcome of Closed Reduction of Developmental Dysplasia of Hip Before First Year of Age, A Retrospective Cohort Study, Saudi Arabia

2020 ◽  
Author(s):  
Fahad AlShayhan ◽  
Abdulmonem Alsiddiky ◽  
Raghad Barri
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Medical Center ◽  
Developmental Dysplasia ◽  
First Year ◽  
Developmental Dysplasia Of Hip ◽  
Class 1 ◽  
One Year ◽  
Skin Traction

Abstract Background: Developmental dysplasia of hip (DDH) management is challenging hence there is no fixed rules or radiographic criteria to assess and manage DDH. There are many treating modalities including closed reduction, open reduction, skin traction, hip Spica and many others. This study is to assess the outcome of closed reduction in patients below 12 months of ages.Method: A retrospective study among patients with DDH who underwent closed reduction before the first year of age in a major referral medical center. The study included 100 patients and 168 hips. Average of follow up period was 5.97 years (±3.01). Couple of variables were measured in AP x ray of pelvis to assess the outcome of closed reduction. Results: Most of the hips were grade 1 and 2 according to the IHDI (International hip dysplasia institution) classification. Significant improvement in the acetabular index post closed reduction. In addition to the normalizing of CE angel's values. Also, majority of hips were severin's class 1 and 2 which were associated with good outcome.Conclusion: Safe closed reduction in patients with DDH below one year of age had a great outcome, less AVN, less growth complications and decrease the need of future open reduction.

scholarly journals Return to work following diagnosis of low-grade glioma

Neurology ◽  
2020 ◽  
Vol 95 (7) ◽  
pp. e856-e866 ◽  
Author(s):  
Isabelle Rydén ◽  
Louise Carstam ◽  
Sasha Gulati ◽  
Anja Smits ◽  
Katharina S. Sunnerhagen ◽  
...  
Keyword(s):  
Sick Leave ◽  
Return To Work ◽  
Adjuvant Treatment ◽  
Older Age ◽  
First Year ◽  
Low Grade ◽  
Diffuse Glioma ◽  
Who Grade ◽  
Female Sex ◽  
One Year

ObjectiveReturn-to-work (RTW) following diagnosis of infiltrative low-grade gliomas is unknown.MethodsSwedish patients with histopathologic verified WHO grade II diffuse glioma diagnosed between 2005 and 2015 were included. Data were acquired from several Swedish registries. A total of 381 patients aged 18–60 were eligible. A matched control population (n = 1,900) was acquired. Individual data on sick leave, compensations, comorbidity, and treatments assigned were assessed. Predictors were explored using multivariable logistic regression.ResultsOne year before surgery/index date, 88% of cases were working, compared to 91% of controls. The proportion of controls working remained constant, while patients had a rapid increase in sick leave approximately 6 months prior to surgery. After 1 and 2 years, respectively, 52% and 63% of the patients were working. Predictors for no RTW after 1 year were previous sick leave (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.88–0.96, p < 0.001), older age (OR 0.96, 95% CI 0.94–0.99, p = 0.005), and lower functional level (OR 0.64 95% CI, 0.45–0.91 p = 0.01). Patients receiving adjuvant treatment were less likely to RTW within the first year. At 2 years, biopsy (as opposed to resection), female sex, and comorbidity were also unfavorable, while age and adjuvant treatment were no longer significant.ConclusionsApproximately half of patients RTW within the first year. Lower functional status, previous sick leave, older age, and adjuvant treatment were risk factors for no RTW at 1 year after surgery. Female sex, comorbidity, and biopsy only were also unfavorable for RTW at 2 years.

FA02.05: PROGRESSION RATE OF BARRETT’S ESOPHAGUS FROM NATIONAL REGISTRY OF EXPERT CENTERS IS MUCH GREATER THAN ANTICIPATED FROM POPULATION STUDIES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 4-4
Author(s):  
Lisa O'Byrne ◽  
Roy Verhage ◽  
Marie O'Brien ◽  
Dermot O'Toole ◽  
Cian Muldoon ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Population Studies ◽  
First Year ◽  
Progression Rate ◽  
Low Grade ◽  
Risk Of Progression ◽  
Low Grade Dysplasia ◽  
One Year

Abstract Background Barrett's Esophagus (BE) is well established as the main pathological precursor for esophageal adenocarcinoma (EAC). Progression to high grade dysplasia (HGD) or EAC varies widely between population based studies and specialized BE registries from high volume centers. No such data existed from the Republic of Ireland until 2011 when a multicenter registry was established involving three centers to more accurately determine the risk of progression to EAC in the Irish population. Methods A detailed clinical, endoscopic and pathological database includes 3397 patients from January 2008 to July 2017, with BE defined by the presence of specialized intestinal metaplasia (SIM). A prospective web based database was used to gather information from three designated esophageal centers with initial and follow up data abstracted by a data manager and overseen by a project manager. Results 325 were excluded following a diagnosis of HGD or EAC at index biopsy, or being a tertiary referral, leaving 3072 with a median age of 61 and a 2.1:1 male to female ratio and a median follow up of 3 years, and 5024 person years. 127 (4%) cases progressed to HGD/EAC, 65 after one year of follow up. 55 (2%) developed EAC were identified, 30 of those within one year. The overall incidence HGD/EAC was 2.53% per year, 1.3% if the first year is excluded. The risk of progression to EAC alone was 1.09% per year, 0.5% excluding the first year. Low grade dysplasia (LGD) on index biopsy was associated with a progression rate of 11.7% per year, 4.2% with the first year excluded. Conclusion With strict data entry and pathologic quality assurance, progression rates for non-dysplastic BE was several fold higher than population studies, highlighting caution in abstracting from population data. True LGD, as evidenced in a recent report by Kestens et al.1 represent high risk disease, with most of the risk evident within the first year. Reference: 1. Kestens C, Offerhaus G, van Baal J, Siersema PD. Patients wtih Barrett's esophagus and persistent low-grade dysplasia have an increased risk for high- grade dysplasia and cancer. Clin Gastroenterol Hepatol. 2016;14:956–962 Disclosure All authors have declared no conflicts of interest.

Pediatric incidental brain tumors: a growing treatment dilemma

2012 ◽  
Vol 10 (3) ◽  
pp. 168-174 ◽  
Author(s):  
Jonathan Roth ◽  
Robert F. Keating ◽  
John S. Myseros ◽  
Amanda L. Yaun ◽  
Suresh N. Magge ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Current Literature ◽  
Management Strategies ◽  
Brain Lesions ◽  
Low Grade ◽  
High Grade ◽  
Observation Group ◽  
Optimal Management ◽  
Tumor Pathology ◽  
Pediatric Disorders

Object Rising numbers of MRI studies performed during evaluations for pediatric disorders have contributed to a significant increase in the number of incidentally found brain tumors. Currently, there is very little literature on the nature of and the preferred treatment for these incidental brain tumors. In this paper the authors review their experience diagnosing and treating these lesions in children as well as the current literature on this topic. Methods Records from 2 centers were reviewed for incidentally found brain tumors, treatment approaches, and outcomes for both surgical and nonsurgical cohorts. Results Forty-seven children (30 males and 17 females) with a mean age of 8.6 years were found to have incidental brain lesions suspected to be neoplasms. Twenty-five underwent surgery and 22 were observed. Two children in the observation group required surgery at a later stage. Tumor pathology in 24 patients was benign. Only 3 patients had high-grade tumors. All nonsurgically treated lesions were presumed to be low-grade tumors and were followed up for 25 ± 20 months. Conclusions The discovery of incidental brain tumors on MRI in children poses an increasing challenge. Additional studies are needed to determine the significance as well as the optimal management strategies in this situation.

scholarly journals Questioning the need for ICU level of care in pediatric patients following elective uncomplicated craniotomy for brain tumors

2016 ◽  
Vol 17 (5) ◽  
pp. 564-568 ◽  
Author(s):  
Brandon C. Gabel ◽  
Joel Martin ◽  
John R. Crawford ◽  
Michael Levy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Tumors ◽  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Level Of Care ◽  
Low Grade ◽  
Tumor Type ◽  
Tumor Pathology ◽  
Adjusted Logistic Regression

OBJECTIVE The object of this study is to address what factors may necessitate the need for intensive care monitoring after elective uncomplicated craniotomy in pediatric patients who are initially managed in a non–intensive care unit setting postoperatively. METHODS A retrospective chart review was undertaken for all patients who underwent elective craniotomy for brain tumor between April of 2007 and April of 2012 and who were directly admitted to the floor postoperatively. Factors such as age, tumor type, craniotomy location, neurological comorbidities, reason for transfer to intensive care unit (ICU) level of care (if applicable), time between admittance to floor and transfer to ICU level of care, and reason for transfer to ICU level of care were assessed. RESULTS Adjusted logistic regression found 2 significant positive predictors of postoperative transfer to the ICU after initial admission to the floor: primitive neuroectodermal tumor pathology (OR 44.10, 95% CI 1.24–1572.16, p = 0.04), and repeat craniotomy during the same hospitalization (OR 13.97, 95% CI 1.21–160.66, p = 0.03). Conversely, 1 negative factor was found: low-grade glioma pathology (OR 0.05, 95% CI 0.00–0.87, p = 0.04). CONCLUSIONS Select pediatric patients may not require ICU level of care after elective uncomplicated pediatric craniotomy. Additional studies are needed to adequately address which patients would benefit from initial ICU admittance following elective craniotomies for brain tumors.

scholarly journals Surgical and seizure outcome in children with DNETs who underwent epilepsy surgery

2015 ◽  
Vol 42 (S1) ◽  
pp. S22-S22
Author(s):  
AM Bueckert ◽  
J Pugh ◽  
T Snyder ◽  
M Wheatley ◽  
F Jacob ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Epilepsy Surgery ◽  
Tumor Resection ◽  
Retrospective Chart Review ◽  
Benign Tumors ◽  
Seizure Outcome ◽  
Low Grade ◽  
Partial Seizures ◽  
Complex Partial Seizures

Background: Dysembryoblastic neuroepithelial tumors (DNETs) are benign tumors of the cerebral cortex that most commonly occur in children or young adults. Seizures are a frequent presenting feature, with an incidence of 80-100%, and are often an indication for surgical resection. Methods: We performed a retrospective chart review of children with DNETs who underwent epilepsy surgery between 1998 and 2014. Results: A total of 12 subjects were identified (6 males, 6 females), all of whom had seizures prior to surgical resection. Of these patients, 1 had infantile spasms, 2 had simple partial seizures and 10 had complex partial seizures. Tumors were located in the temporal (n=7), frontal (n=3) or parietal (n=2) cortex. These patients went on to have surgery on average 15 months after seizure onset, 3 had incomplete resections. At an average follow up of 6 years 4 months, all patients were class 1 on Engel’s Classification. All but one subject with rare non-disabling seizures were seizure free, with only 6 on medication. Follow up MR imaging revealed tumor recurrence in 1 subject. Conclusions: Despite differing seizure seminology and tumor location, surgical resection of these low-grade tumors resulted in excellent seizure outcome even in the setting of incomplete tumor resection.

Sign in / Sign up

Export Citation Format

Share Document