QOL-02EPILEPSY FOLLOWING LOW GRADE GLIOMA SURGERY: SINGLE CENTRE EXPERIENCE

Abstract

Objectives. Review the incidence of seizures and the value of prophylactic antiepileptic drug (AED) treatment following surgery for Low-Grade Gliomas (LGGs). Design. Retrospective study Subjects. All patients who underwent surgery for LGG between 2010 and 2015 at our centre Results. 91 out of 137 patients received AEDs preopera-tively; 70 due to initial presentation with seizures and 21 prophylactically. 20/137 patients (14.6%) had seizures in the immediate postoperative period (< 14 days). Incidence of seizures in the immediate postoperative period was sig-nificantly lower in patients established on AEDs compared to the ones who received AEDs as prophylaxis or did not receive AED at all (10.0 vs 28.57 vs 15.22%, p = 0.10), but this difference became insignificant in the follow-up period of 1 year (p = 0.69). 35 craniotomies were performed awake; seizures in the immediate postoperative period were more frequent in awake surgery but this was not significant (20 vs 12.75%, p = 0.29). The extent of resection demonstrated an inverse trend on seizures at 1 year; only 3.3% of the patients who underwent total resection suffering seizures vs 12.5% of near total and 19.51% subtotal debulking or biopsy (p = 0.09). Conclusions. Patients established on regular AEDs tend to have fewer seizures in the immediate post-operative period, but this difference becomes insignificant at 1 year. Awake craniotomy has no significant impact in the immediate- and long-term seizure activity. The extent of resection is a valid prognostic predictor of seizure activity.