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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study, an analysis of variable prognostic factors affecting the treatment outcome for patients with oligodendroglioma, included a retrospective analysis of the medical charts of patients diagnosed with oligodendroglioma treated at our institution between 1975 and 1997. The endpoints analyzed were the progression-free survival (PFS), as well as the overall survival. The factors analyzed included extent of surgery, postoperative radiotherapy, pathologic grade, performance status, age, and sex. Of a total of 37 cases, 19 were male and 18 were female. The median age at diagnosis was 30 years. The most common presenting symptoms were headache (78%), seizures (43%), motor symptoms (38%), and to a lesser extent behavioral changes (16%). The median duration of symptoms was 9 months. The most common location on computed tomography or magnetic resonance imaging scans was the frontal region (43%). Low grade tumors (grades I and II) were found in 60% of patients, and the remaining 40% had high grade tumors (grades III and IV). Eight patients had complete surgical excision, whereas 27 patients had partial excision, and two patients had biopsy only. The operative mortality rate was 14%. There were 24 patients who received postoperative radiotherapy, and only 3 patients received adjuvant chemotherapy. The median postoperative radiation dose was 5,580 cGy. With a median follow-up of 7 years, the 5-year PFS and overall survival for the whole group were 58% and 67%, respectively. The pathologic grade of the tumor was the only prognostic factor significantly affecting both PFS and overall survival. The 5-year PFS for patients with low grade tumors was 79% in comparison to 32% for patients with high grade tumors (p < 0.01). Patients with good performance status at initial presentation (performance status of 1 and 2) had a higher 5-year PFS in comparison to those with poor performance status (62% vs. 38%, respectively); however, this difference did not reach statistical significance. Similarly, patients who were subjected to complete surgical excision had a marginally higher PFS in comparison to those who had biopsy or partial excision (75% vs. 53%). There was no difference in the 5-year PFS between patients who received postoperative irradiation versus those who did not (51% vs. 47%, respectively). Patients with high grade oligodendrogliomas have a relatively poor prognosis. The pathologic grade of the tumor was the single most important prognostic factor significantly affecting both the PFS and overall survival. A prospective randomized clinical trial is needed to address the impact of postoperative irradiation on PFS of those tumors. In view of the poor outcome for patients with high grade oligodendroglioma, the use of adjuvant systemic chemotherapy should be studied in future multicenter randomized trials.
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PMID:Oligodendroglioma: an analysis of prognostic factors and treatment results. 1077 79

This series reports a pilot study of chemotherapy conducted for newly diagnosed and relapsing patients with oligodendrogliomas and oligoastrocytomas. Twenty-three patients with clinically or histologically aggressive tumours were eligible to receive procarbazine CCNU and vincristine (PCV) chemotherapy followed by radiotherapy in previously non irradiated patients. Sixteen (69%) responded to chemotherapy with complete responses in two patients and partial responses in 14. Previously irradiated patients were as likely to respond to PCV as those previously non irradiated. An over 1-year history of seizures was the main clinical prognostic factor of response. All toxicities were manageable and no treatment related deaths occurred. Chemotherapy is an effective treatment in aggressive oligodendrogliomas. Further studies must assess the role of chemotherapy in the multidisciplinary management of oligodendroglioma.
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PMID:Chemotherapy for aggressive or anaplastic high grade oligodendrogliomas and oligoastrocytomas: better than a salvage treatment. 1101 83

Two hundred patients with supratentorial glioma; astrocytoma (pilocytic, fibrillary, gemistocytic) 82, mixed glioma (oligoastrocytoma) 46, oligodendroglioma 8, malignant (anaplastic) astrocytoma 33 and glioblastoma multiforme 31, surgically treated for the tumours and followed up for one to sixteen years, were retrospectively analysed for the incidence of pre and postoperative epileptic seizures. 122 patients (61%) had seizures preoperatively. 62 (50.8%) of them had at least one or more seizures during follow up. Seizures were persistent in 22 patients. Doubtful, or one or two minor seizures occurred in 19 cases. Six patients in this group had seizure only at the time of CT confirmed recurrence, after a seizure free interval of one to nine years. Amongst 78 patients who did not have seizures preoperatively, 24 (30.6%) developed seizures during the postoperative follow up period. Recurrent attacks were reported only by 5 patients while 15 patients had seizure(s) only at the time of recurrence of tumour. Two patients had a few seizures in the early postoperative period and none thereafter, while doubtful seizures were reported by two patients.
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PMID:Epileptic seizures in supratentorial gliomas. 1130 43

The most common cause of focal epilepsies is the morphological brain abnormality, the epileptogenic lesion. Nowadays, by using MRI, the epileptogenic lesion can be demonstrated in vivo in more and more cases. Our knowledge regarding the clinical and pathophysiological features of epilepsy should be reevaluated in the highlight of the epileptogenic lesions demonstrated by MRI. The presence and the type of the epileptogenic lesion are important prognostic factors in the pharmacological and surgical treatments of epilepsy. Because the localization of the lesion is usually identical with the site of the seizure onset, the MRI investigation play an important role not only in identifying the epilepsy etiology but also in the non-invasive localization of the epileptic focus. Tumors, malformations of the cortical development, the hippocampal sclerosis, perinatal lesions, posttraumatic scars and the vascular malformations are the most important morphological abnormalities associated with epilepsy. Low-grade astrocytoma, pilocytic astrocytoma, oligodendroglioma, ganglioglioma, and the dysembrioplastic neuroepithelial tumors are the most common neoplasms associated with chronic epilepsy. Low grade astrocytomas or vascular malformations generate seizures due to chemical or mechanical effects of the lesion, the pacemaker area occurs obviously outside the lesion, in the adjacent brain tissue. Conversely, malformations of cortical development have intrinsic epileptogenicity. In them, the seizure onset zone is localized intralesional: the lesion generates seizures itself.
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PMID:[Role of epileptogenic lesions in the development of ictal and interictal epileptic disturbance]. 1205 50

A 48-year-old woman was admitted to the Neurosurgery Department for a large frontal lobe tumor revealed by partial seizures. The patient was conscious and alert. Neurological examination was normal. MRI study showed a right frontal lobe tumor compounded of an anterior solid mass strongly enhanced after gadolinium injection and a posterior voluminous cyst with important mass effect. The cerebral blood volume (CBV) map showed no area of elevated CBV within the tumor consistent with a low-grade tumor. The patient was operated on with a presumed diagnosis of anaplastic oligodendroglioma. Postoperative course was uneventful. Histopathological examination was consistent with a benign ganglioglioma. The patient did not undergo an additional treatment. One year later, the patient was healthy and neurological and neuropsychological examination were normal. MRI study did not show any recurrence. This case emphazises the relevance of perfusion MR imaging in the preoperative workup of glioneuronal and glial tumors.
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PMID:[Contribution of perfusion magnetic resonance imaging in a patient with cerebral ganglioglioma]. 1248 21

Primary central nervous system lymphomas and anaplastic oligodendrogliomas are not uncommon; however, no association between the 2 has been documented to date. We describe a unique case, whereby a patient presenting with seizures and slight impairment of higher functions, underwent frontal lobectomy for a mass lesion. The histology revealed dual pathology of anaplastic oligodendroglioma and B cell non-Hodgkin lymphoma. Postoperatively, the patient received whole brain radiotherapy. The patient remained well after 18 months of follow-up with no radiological progression of a known tumor residuum.
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PMID:B cell non-Hodgkin cerebral lymphoma associated with an anaplastic oligodendroglioma. 1248 71

Epileptic seizures are common in patients with cerebral metastases as well as in patients with primary brain tumors. In cancer patients without primary brain tumors or brain metastasis, epileptic seizures may occur due to metabolic or toxic causes, or due to infections. We performed a retrospective analysis from our neurooncological database concerning the occurrence of seizures in patients with primary brain tumors, patients with cerebral metastases and in cancer patients without brain tumors. Patients with low grade gliomas, such as astrocytoma WHO I + II (69%), oligodendroglioma WHO II (50%), and mixed glioma WHO II-III (56%) were more likely to have seizures than patients with anaplastic glioma WHO III (44%), glioblastoma WHO IV (48%) or meningeoma (45%). In patients with brain metastasis, melanoma (67%), cancer of the lung (29%), and gastrointestinal tumors (21%) were the primaries with the highest frequency of seizures. In cancer patients without brain metastases or primary brain tumors, seizures occurred in 4%. In conclusion, the occurrence of epileptic seizures in patients suffering from primary brain tumors, as well as in patients with cerebral metastases, varied within the tumor entity. Therefore, especially in brain tumors where a higher probability of epileptic seizures is expected, they should be taken into account in the care of cancer patients.
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PMID:[The frequency of seizures in patients with primary brain tumors or cerebral metastases. An evaluation from the Ludwig Boltzmann Institute of Neuro-Oncology and the Department of Neurology, Kaiser Franz Josef Hospital, Vienna]. 1252 23

This study reports the University of Florida experience treating oligodendrogliomas with the goal of identifying the factors that predict favorable outcome. Between 1958 and June 1998, 51 patients (aged 5-75 years) were diagnosed with pure oligodendroglioma at the University of Florida. Histologic grade was anaplastic in 19 patients, low-grade in 30 patients, and unknown in one patient. Twelve patients were treated with surgery alone (10 with low-grade tumors). Thirty-nine patients underwent postoperative radiotherapy after surgery (plus chemotherapy in four patients). A biopsy was performed in 10 patients, 40 underwent subtotal or gross total resection, and one had surgery of unknown extent. Thirteen patients with a radiographic abnormality consistent with a low-grade glioma had the initiation of definitive treatment (i.e., surgery with or without radiotherapy) deferred for a median of 4.5 years before undergoing treatment for worsening symptoms or radiographic progression. Absolute survival for the entire group (51 patients) at 5, 10, and 20 years from the date of initial treatment was 61%, 37%, and 31%, respectively, and at 5, 10, and 20 years from the date of initial diagnosis was 65%, 43%, and 34%, respectively. No patient died of intercurrent disease. Multivariate analysis for absolute survival from the time of initial treatment demonstrated young age (young patients fared better than older patients) and size (<5 cm better than > or =5 cm) to be significant variables. No patient under the age of 21 years (n = 8) at the time of diagnosis has died in this series. Deferring aggressive treatment did not alter survival. Multivariate analysis for favorable absolute survival based on the time from initial diagnosis demonstrated young age and presentation with seizures alone to be statistically significant for favorable outcomes. Approximately one third of patients with oligodendroglioma appear to be cured with aggressive treatment. Age is the most important predictor of long-term progression-free and absolute survival with young patients (especially aged <21 years) doing much better than older patients. Deferring aggressive treatment (surgery and/or radiation) until symptoms clearly indicate tumor progression does not compromise outcome for a select group of patients who are diagnosed at a young age with a nonenhancing mass on MR and seizures as the lone presenting symptom.
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PMID:Oligodendroglioma: does deferring treatment compromise outcome? 1279 17

A 4-year-old girl had repetitive attacks of chest pain, palpitation and loss of consciousness, which lasted for a few minutes and occurred several times a day. Interictal and ictal EEGs revealed that these episodes were complex partial seizures with autonomic symptoms originating from the right antero-temporal area. Brain MRI depicted a tumor in the right temporal lobe, the suspected etiology of the seizures. The tumor and its surrounding area were carefully resected using electrocorticogram. Pathologically, the tumor was diagnosed as an oligodendroglioma. MR spectrometry demonstrated a definite reduction of NAA/creatine ratio in the tumor. It is reported that a probability of developing seizures in cases of oligodendroglioma is about 80-90%. The occurrence rate of seizures in oligodendroglioma is much higher than that in other brain tumors. The cause of the epileptogenesis in oligodendroglioma might be due to the pathological tissue of satellitosis and secondary degeneration of neurons.
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PMID:[A case of oligodendroglioma with temporal lobe epilepsy initially suspected as having paroxymal tachycardia]. 1367 49

Protoplasmic astrocytomas are rare gliomas whose nosology remains enigmatic. This study retrospectively reviews the clinicopathologic features of eight tumors, including evaluation of these neoplasms for chromosome 1p loss, Bcl-2 immunoreactivity, and cyclooxygenase-2 immunoreactivity. Patients ranged in age from 3 to 49 years (median 25.5 years) and included six males and two females. All patients presented with a period of seizures (median duration of period, 54 months) before surgery. Five tumors were either totally or partially based in the temporal lobe. In the six patients for whom follow-up information was available, there was no evidence of recurrence at last known follow-up (range 5 to 171 months; median 134 months). Histologically, all tumors were marked by a proliferation of cells with rounded to oval nuclear contours and a paucity of cytoplasmic processes, arranged against a microcystic background. A rare mitotic figure was observed in only one tumor. Vascular proliferative changes and necrosis were not seen in any of the tumors. None of the tumors showed allelic loss on chromosome 1p by fluorescent in situ hybridization (FISH) analysis. Cyclooxygenase-2 (an enzyme involved in the conversion of arachidonate to prostaglandin H2 and G2) immunoreactivity was observed in two tumors. Bcl-2 (an anti-apoptotic protein) immunoreactivity was also confined to two tumors. In conclusion, protoplasmic astrocytomas appear to be low-grade neoplasms, as evidenced by their relatively benign clinical course. Although they histologically resemble microcystic oligodendrogliomas, none of the tumors showed allelic loss on chromosome 1p, a finding that has been described in the majority of low-grade oligodendrogliomas. This suggests that the protoplasmic astrocytoma is a distinct entity from low-grade oligodendroglioma. Similar to other low-grade astrocytomas, only a minority of tumors show evidence of cyclooxygenase-2 and Bcl-2 immunoreactivity.
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PMID:Cyclooxygenase-2, Bcl-2, and chromosome 1p analysis in protoplasmic astrocytomas. 1501 87


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