Rates of Seizure Freedom After Surgical Resection of Diffuse Low-Grade Gliomas

Abstract

Objective: Patients with diffuse low-grade gliomas (DLGGs) typically present with seizures. We sought to review the neurosurgical literature for seizure outcome after resection of these tumors.

Methods: Using PubMed, we identified surgical series reporting seizure freedom rates for grade II astrocytoma, oligoastrocytoma, and oligodendroglioma. Inclusion criteria included seizure outcomes reported specifically for DLGGs and at least 10 patients with follow-up data.

Results: Twelve articles met the inclusion criteria. The median seizure-free rate after surgery in these patients was 71%, with an interquartile range of 64%-82%. In 10 studies, more than 60% of patients were seizure free. Studies used varying reporting times for seizure outcome determination. In the 6 studies that reported postoperative antiepileptic medication use, 5%-69% of seizure-free patients were weaned off these agents (median, 32%). The durability of seizure freedom has not been clearly studied to date. The most commonly reported prognostic factor for seizure freedom after resection was increasing extent of resection.

Conclusions: Among articles reporting seizure outcomes after resection of DLGG, the median seizure-free rate was 71% (interquartile range, 64%-82%). Seizure freedom is likely associated with extent of resection.

Keywords: Astrocytoma; Low-grade glioma; Oligoastrocytoma; Oligodendroglioma; Resection; Seizure; Surgery.