Tumors and Tumoral Epilepsy
Is an epilepsy presurgical evaluation necessary for mid-grade and high-grade brain tumors presenting with seizures?
Article first published online: 12 DEC 2013
Wiley Periodicals, Inc. © 2013 International League Against Epilepsy
Special Issue: Tumors and tumoral epilepsy
Volume 54, Issue Supplement s9, pages 56–60, December 2013
How to Cite
Hamer, H. M. and Hong, S. B. (2013), Is an epilepsy presurgical evaluation necessary for mid-grade and high-grade brain tumors presenting with seizures?. Epilepsia, 54: 56–60. doi: 10.1111/epi.12445
- Issue published online: 12 DEC 2013
- Article first published online: 12 DEC 2013
- Tumor-related epilepsy;
- Mid-grade glioma;
- Epilepsy surgery;
- Presurgical evaluation
Patients with epilepsy caused by mid-grade and high-grade tumors do not usually undergo formal presurgical epilepsy evaluations before tumor resection. However, a minority of these patients may benefit significantly from just such a structured presurgical evaluation especially when seizure freedom or seizure reduction is a surgical aim in addition to total tumor resection. Typical cases comprise patients with multifocal tumors, tumors with bilateral extension, tumors over eloquent cortex, and the need for differentiation of spells of an uncertain nature, for example, epileptic versus psychogenic nonepileptic seizures. If they are epileptic, the definition of the epileptic lesion versus the epileptogenic zone and eloquent cortex can be another reason for monitoring. In addition to noninvasive recordings, invasive studies that use subdural or depths electrodes can be of special importance in these patients, leading to an exact delineation of the epileptogenic zone, usually extending beyond the epileptic lesion, and allow safe differentiation of epileptic from eloquent cortex.