Abstracts

Rationale: Epilepsy is a significant burden in already vulnerable patients with primary brain tumours. We have begun a study to assess the incidence and impact of seizures on cognition and health related quality of life in this group of patients with primary brain tumours.Methods: We collected patients from tumour surgery and epilepsy surgery databases and prospectively from medical oncology, epilepsy and neurosurgery outpatient clinics from January 2010 to May 2013. We are using Montreal Cognitive Assessment (MoCA) tool and Frontal Assessment Battery (FAB)for cognitive assessment; Quality of Life in Epilepsy -31( QOLIE-31) and Functional Assessment in Cancer Therapy brain subscale (FACT-Br) for quality of life assessment, Hospital Anxiety and Depression Scale (HADS) for mood assessment and Karnofsky Performance Status (KPS) and Berthel Index for assessing performance status.Results: Total 254 patients were diagnosed with primary brain tumours. (M:F= 1:1.2, mean age=44). Glioblastoma multiforme (GBM) 75(29.5%), Oligodendroglioma 26(11%), astrocytoma 25(10%), oligoastrocytoma 8(3%), meningioma 74 (29.5%), DNET 3(1%), ganglioglioma 3(1%), acoustic neuroma 7(3%) and other. 140(55%) patients were diagnosed with either seizures or epilepsy. Cortical tumours (160): 70% of WHO I, 81.5% WHO II, 71% WHO III, 44% WHO IV developed seizures. WHO grade I, II and III showed highest incidence which is statistically significant (P<0.01). As per KPS scale 34(89.5%) patients were independent, 1(3%) dependent and 3 (8%) needs assistance. 19(55.88%) out of 34 patients showed cognitive impairment (Montreal Cognitive Assessment tool); 14(74%) with Sz and 5(26%) with out Sz (P<0.01%). 31 patients had frontal executive functions assessed with FAB (Frontal Assessment Battery). 1 patient with and 1 patient without Sz had frontal executive dysfunction. 32 had mood assessment done HADS). 7 with Sz and 3 without Sz had either borderline or clinical depression and 5 patients with seizure and 2 patients without seizure had borderline or clinical anxiety. Both depression and anxiety occurred in 4 patients (3 sz, 1 no sz). All 4 patients with poor performance status had either cognitive impairment or mood disturbance.Conclusions: Our preliminary data showed the similar incidence of epilepsy and histopathological and WHO grading correlation of seizure occurrence and primary brain tumours. Patients with seizures had higher incidence of cognitive impairment in comparison to those who did not have seizures. There is no statistically significant difference in depression and anxiety in two groups.