Epilepsy in Adults with Supratentorial Glioblastoma: Incidence and Influence Factors and Prophylaxis in 184 Patients

• Published in: PloS one 2016-07, Vol.11 (7), p.e0158206-e0158206
• Main Authors: Liang, Shuli, Zhang, Junchen, Zhang, Shaohui, Fu, Xiangping
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Anticonvulsants - administration & dosage; Antiepileptic agents; Biology and Life Sciences; Brain cancer; Brain research; Care and treatment; Chemotherapy; Complications and side effects; Craniotomy; Diagnosis; Drugs; Epilepsy; Epilepsy - complications; Epilepsy - drug therapy; Epilepsy - physiopathology; Epilepsy - surgery; Female; Frontal Lobe - drug effects; Frontal Lobe - pathology; Frontal Lobe - surgery; Glioblastoma; Glioblastoma - complications; Glioblastoma - drug therapy; Glioblastoma - surgery; Glioblastomas; Hospitals; Humans; Incidence; Lobes; Male; Medicine and Health Sciences; Middle Aged; Neurology; Neurosurgery; NMR; Nuclear magnetic resonance; Patients; Phenytoin - administration & dosage; Prophylaxis; Quality of life; Radiation therapy; Retrospective Studies; Risk factors; Seizing; Seizures; Seizures - complications; Seizures - drug therapy; Seizures - surgery; Studies; Supratentorial Neoplasms - complications; Supratentorial Neoplasms - drug therapy; Supratentorial Neoplasms - surgery; Systematic review; Temporal Lobe - drug effects; Temporal Lobe - pathology; Temporal Lobe - surgery; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0158206

To analyze the incidence of epilepsy in adult patients with supratentorial glioblastoma, assess the factors influencing the development of epilepsy in these cases, and evaluate patients' response to antiepileptic drugs (AEDs) in a series of 184 patients. We retrospectively analyzed the 184 adult patients diagnosed with supratentorial glioblastoma. All subjects were treated within our hospital and subsequently died between 2003 and 2013. The incidence of epilepsy was assessed before and after initial resection and reexamined every 2 months thereafter. We evaluated the efficacy of prophylactic AEDs in this patient population based on the gathered incidence data. Of 184 patients, 43 (23.37%) were diagnosed with epilepsy before their initial resection. The total incidence of epilepsy (both pre- and postoperative) was 68.48%. The prevalence of active epilepsy reached over 80% in patients with epilepsy and survival of greater than 13 months postoperatively. Patients with glioblastoma in the frontal and/or temporal lobes had a higher prevalence of epilepsy. In the 43 patients with preoperative epilepsy, total resection of glioblastoma resulted in significantly lower seizure frequency. Patients who received epilepsy prophylaxis with AEDs for at least 6 months had significantly fewer seizures and higher Karnofsky scores than those receiving AEDs for less than one month or not at all. The incidence of epilepsy in adult patients with glioblastoma was high and responded poorly to AEDs in the short term. However, when taken for longer periods, AEDs can reduce the frequency of seizures in patients with glioblastoma.