Value of ambulatory electroencephalogram in evaluation of postoperative withdrawal of antiepileptic drugs in patients with glioma-related epilepsy

Xinyi LIANG; Wei DAN; Daifen JIANG; Huan LIAN; Xin LI; Yanfeng XIE; Quanhong SHI; Yan ZHAN

doi:10.16016/j.2097-0927.202107129

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Value of ambulatory electroencephalogram in evaluation of postoperative withdrawal of antiepileptic drugs in patients with glioma-related epilepsy

Clinical Medicine | 更新时间：2026-01-09

- Value of ambulatory electroencephalogram in evaluation of postoperative withdrawal of antiepileptic drugs in patients with glioma-related epilepsy
- Journal of Army Medical University Vol. 44, Issue 7, Pages: 718-723(2022)
- 作者机构：
  
  400016 重庆，重庆医科大学附属第一医院神经外科
- 作者简介：
- 基金信息：
  
  the National Clinical Key-Discipline Construction Program of China((2011)170号);the Key Project of Chongqing Municipal Health Bureau(2012-1-008)
- DOI：10.16016/j.2097-0927.202107129
  CLC： R730.264;R741.044;R742.1
- Received：19 July 2021，
  
  Revised：2021-10-10，
  
  Published：15 April 2022
- 稿件说明：
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Xinyi LIANG, Wei DAN, Daifen JIANG, et al. Value of ambulatory electroencephalogram in evaluation of postoperative withdrawal of antiepileptic drugs in patients with glioma-related epilepsy[J]. Journal of Army Medical University, 2022, 44(7): 718-723.
DOI：

Xinyi LIANG, Wei DAN, Daifen JIANG, et al. Value of ambulatory electroencephalogram in evaluation of postoperative withdrawal of antiepileptic drugs in patients with glioma-related epilepsy[J]. Journal of Army Medical University, 2022, 44(7): 718-723. DOI： 10.16016/j.2097-0927.202107129.

摘要

目的

探讨术前有胶质瘤相关癫痫(glioma related epilepsy，GRE)病史的患者术后停药前动态脑电图(ambulatory electroencephalogram，AEEG)异常是否与癫痫复发相关。

方法

回顾性分析本院2014年1月至2020年6月68例行手术治疗且长期随访的GRE患者AEEG及临床资料

根据停用抗癫痫药后是否出现癫痫复发，将病例分为发作组(停药后癫痫复发)和对照组(停药后无癫痫发作)，分析两组棘尖波及阵发性慢波事件(paroxysmal slow wave events，PSWEs)出现率、数量差异。通过回顾性分析停药前AEEG显示有痫性放电的47例患者临床资料，探讨影响其癫痫预后的因素。

结果

① 发作组31例患者停药前AEEG中有痫性放电者29例(93.5%)，有PSWEs者11例(35.5%)，对照组37例患者停药前AEEG中有痫性放电者18例(48.6%)，有PSWEs者5例(13.5%)。发作组与对照组之间棘尖波及PSWEs出现率差异具有统计学意义(

＜0.05)。②发作组棘尖波及慢波数量明显高于对照组，发作组主要以中大量棘尖波(25/29，86.2%)及大量阵发性慢波(8/11

72.7%)为主，对照组主要以少量棘尖波(14/18

77.8%)及少中量阵发性慢波(4/5

80.0%)为主。③伴有AEEG痫性放电时，肿瘤切除程度及肿瘤累及皮层与癫痫预后有关(

＜0.05)。

结论

当肿瘤为次全切除或肿瘤累及皮质，同时停药前AEEG显示中量、大量棘尖波及PSWEs时，需考虑减缓停药，延长患者无发作间隔时间以降低癫痫复发风险。

Abstract

Objective

To explore whether the abnormality of ambulatory electroencephalogram (AEEG) prior to postoperative drug withdrawal is related to the recurrence of epilepsy after drug discontinuation in patients with glioma related epilepsy (GRE).

Methods

The clinical data and AEEG of 68 GRE patients who underwent surgical treatment in our hospital with long-term follow-up from January 2014 to June 2020 were collected and retrospectively analyzed. The patients were subsequently divided into seizure group (seizure recurrence after withdrawal of antiepileptic drugs

=31) and control group (no seizure after withdrawal

=37). The differences in the occurrence rate and number of spike waves and paroxysmal slow wave events (PSWEs) were analyzed and compared between the 2 groups. The factors affecting the prognosis of epilepsy were discussed through analyzing the data of 47 patients who presented epileptic discharge on AEEG before drug discontinuation.

Results

① In the seizure group

29 patients (93.5%) had epileptic discharges on AEEG before drug withdrawal

and 11 (35.5%) showed PSWEs

while there were only 18 (48.6%) and 5 (13.5%) patients correspondingly in the control group

indicating a significant difference in the occurrence rate between the 2 groups (

0.05). ② The number of spike and slow waves was significantly larger in the seizure group than the control group. In the seizure group

medium to large number of spike waves (25/29

86.2%) as well as large number of paroxysmal slow waves (8/11

72.7%) were predominant

whereas the control group mainly had small amount of spike waves (14/18

77.8%) and small to medium amount of paroxysmal slow waves (4/5

80.0%). ③ With epileptic discharge of AEEG

the extent of tumor removal and involvement of cortex were related to the epilepsy prognosis (

0.05).

Conclusion

When the tumor is sub-radical resected or the tumor involves the cortex

and the pre-discontinuation AEEG shows moderate to large number of epileptic discharge and PSWEs

it is necessary to consider suspending drug withdrawal and extending the interval between seizures to reduce the risk of seizure recurrence.

关键词

Keywords

references

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