Abstracts

Rationale: About 60% of brain tumor patients will experience seizure at least once during their illness.  Primary brain tumors account for 5% of new onset seizures in adults and over 10% of lesional focal epilepsies.  The goal to treat these patients includes: improve survival rate, seizure control and quality of life. This can potentially be achieved with total tumor resection. We reviewed 5 patients who had resective surgery of the low grade glial or neuroglial tumor, later they were re-evaluated for epilepsy surgery due to the medically refractory seizures. Methods: We reviewed 5 patients who had resective surgery of the low grade glial or neuroglial tumor, later they were re-evaluated for epilepsy surgery due to the medically refractory seizures (see Table). There are 4 female and one male patients, age of 4, 6, 6, 9 and 26 years. The reevaluation included structural MRI with epilepsy protocol, long term video EEG recording, MEG as well as invasive ECoG (2 patients).   Results: Three patients underwent further resective surgery, 2 patients have been seizure free after the complete resection of epileptogenic region defined by structural MRI, MEG and invasive EEG; one patient experienced partial resection to avoid neurological deficit, her seizure has been improved significantly; one patient with 2 previously “gross total” resection, is pending for another surgical intervention. One patient could not precede for resective surgery due to potential neurological deficit.Figure. Pt KW.  Top panel – MR images after first tumor resection surgery of right temporal lobe; middle panel -  MSI interictal spikes at posterior resection margin; lower panel – extended right temporal lobectomy plus hippocampus resection demonstrated on MR images after the 2^nd surgery. Conclusions: Conclusion: Based on our limited data, we recommend that epilepsy-associated brain tumor should be evaluated with both structural imaging and EEG/MEG. If possible, complete and generous resection is performed to improve seizure control and quality of life. Funding: Not applicable