• Anant Mehrotra, Suyash Singh, Soumen Kanjilal, Ashutosh Kumar, Lily Pal, Vrinda Mathur, Vimal K Paliwal, Jayesh Sardhara, Kamlesh Singh Bhaisora, Arun Kumar Srivastava, Awadhesh K Jaiswal, and Sanjay Behari.
• Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. Electronic address: dranantmehrotra@gmail.com.
• World Neurosurg. 2020 Dec 1; 144: e149-e155.

BackgroundTumors presenting with drug-resistant seizures are termed as long-term epilepsy-associated tumors (LEATs). LEATs are more common in the temporal lobe, occur predominantly in pediatric age, and focal neurological deficits are rare. In this article, we aim to highlight our surgical experience in terms of seizure outcome among LEATs and discuss the factors affecting outcome.MethodologyWe have retrospectively analyzed all the operated cases of intra-axial brain tumors with seizures (2015-2019). The clinical and radiographic data were collected from the hospital record system. For comparison, 2 groups were made (group 1 with good seizure control, i.e., Engel 1; and group 2 poor seizure outcome, i.e., Engel 2 and 3).ResultsA total of 51 cases were included; the temporal lobe was the most common location (n = 27); 23 patients had seizure frequency of "more than 1 seizure per week." Focal unaware seizures/complex partial seizures were the most common type of seizures encountered (n = 28). At a mean follow-up of 39.60 months, 38 patients had Engel 1 (78.5%) outcome (35 cases [71.05%] had the seizure duration of ≤2 years). The median duration of symptoms (group 1, 25 months vs. group 2, 65 months) was significantly different (P = 0.002). On comparing patients with seizure duration, we found a statistically significant difference (P < 0.00001).ConclusionA shorter duration of symptoms, younger age of the patient, partial/focal seizures, and gross total excision were predictors of a good seizure outcome. Histopathology of the tumor does not affect the outcome when one compares glioneuronal tumors with non-glioneuronal tumors.Copyright © 2020 Elsevier Inc. All rights reserved.

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