Gross-total resection of temporal low grade gliomas is a critically important factor in achieving seizure-freedom

Abstract

Objective: To present a surgical series of patients with low grade temporal gliomas causing intractable epilepsy, focusing on long-term seizure outcome. Method: A retrospective study was conducted with patients with temporal low-grade gliomas (LGG). Results: Sixty five patients with were operated in our institution. Males were more affected than females and the mean age at surgery was 32.3 ± 8.4 (9-68 years). The mean age at seizure onset was 25.7 ± 9.2 (11-66 years). Seizure outcome was classified according with Engel classification. After one year of follow up, forty two patients (64.6%) were Engel I; seventeen (26.2%) Engel II; four (6.2%) Engel III and two (3.1%) Engel IV. Statistically significant difference in seizure outcome was obtained when comparing the extension of resection. Engel I was observed in 39 patients (69.6%) with total resection and in only 3 (33.3%) patients with partial resection. Conclusion: Gross-total resection of temporal LGGs is a critically important factor in achieving seizure-freedom._________________________________________________________________________________________ RESUMO: Objetivo: Apresentar uma série cirúrgica de pacientes com gliomas temporais de baixo grau, causando epilepsia de difícil controle. Método: Estudo retrospectivo de pacientes com diagnóstico de glioma temporal de baixo grau temporais. Resultados: 65 pacientes com foram operados em nossa instituição. A média de idade de início das crises foi de 25,7 ± 9,2 (11-66 anos). Após um ano de acompanhamento, quarenta e dois pacientes (64,6%) estavam Engel I; dezessete (26,2%) Engel II; quatro (6,2%) Engel III e dois (3,1%) Engel IV. Houve diferença estatisticamente significativa no resultado do controle das crises quando se compara a extensão da ressecção. Engel I foi observada em 39 pacientes (69,6%) com a ressecção total e em apenas 3 (33,3%) pacientes com ressecção parcial. Conclusão: A ressecção total de glioma temporal de baixo grau temporais é um fator extremamente importante no controle das crises.