J Neurol Surg A Cent Eur Neurosurg 2022; 83(04): 351-360
DOI: 10.1055/s-0041-1735515
Original Article

IDH Wild-type Glioblastoma Presenting with Seizure: Clinical Specificity, and Oncologic and Surgical Outcomes

Alessandro Pesce
1   “Santa Maria Goretti” Hospital, Latina, Italy
,
2   Division of Neurosurgery, Department of Human Neurosciences, “Sapienza” University, Rome, Italy
,
Francesco Paglia
2   Division of Neurosurgery, Department of Human Neurosciences, “Sapienza” University, Rome, Italy
,
Mauro Palmieri
2   Division of Neurosurgery, Department of Human Neurosciences, “Sapienza” University, Rome, Italy
,
Alessandro Frati
2   Division of Neurosurgery, Department of Human Neurosciences, “Sapienza” University, Rome, Italy
3   IRCCS “Neuromed” Pozzilli (IS), Italy
,
Giancarlo D'Andrea
4   Department of Neurosurgery, “Spaziani” Hospital, Frosinone, Italy
,
Maurizio Salvati
3   IRCCS “Neuromed” Pozzilli (IS), Italy
5   Department of Mental and Neurological, Dental and Sensory Organs Health, Tor Vergata University, Rome Italy
,
Antonio Santoro
1   “Santa Maria Goretti” Hospital, Latina, Italy
› Author Affiliations
Funding None.

Abstract

Background Glioblastoma (GBM) is the most common and aggressive primary brain neoplasia in adults. Seizure is a common manifestation in GBM. Up to 25 to 60% of patients with GBM have seizures. We aim to summarize all the relevant clinical, surgical, radiologic, and molecular features of a cohort of patients suffering from GBM-related epilepsy and measure the outcome, to understand the possible existence of a clinical/phenotypical specificity of this subgroup of patients.

Methods We retrospectively analyzed a cohort of 177 patients affected by isocitrate dehydrogenase wild-type (IDH-WT) GBM; 49 patients presented seizure at onset (SaO) and 128 were seizure free (SF). We investigated the relationship between seizures and other prognostic factors of GBMs.

Results A statistically significant association between the location of the lesions in the parietal lobe and seizures was observed. The left side was more commonly affected. Interestingly, there was a statistical relationship between tumors involving the subventricular zone (SVZ) and SaO patients. The tumors were also smaller on average at diagnosis, and generalized SaOs were associated with longer overall survival.

Conclusions The typical patient with IDH-WT GBM with SaO is a young (<55 year) male without a history of headache. The lesion is typically small to medium in size and located in the temporoparietal dominant lobe, with a high tendency to involve the SVZ.



Publication History

Received: 14 September 2020

Accepted: 09 March 2021

Article published online:
18 November 2021

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