Epilepsy Surgery Outcomes in Patients with Drug-Resistant Forms with Low-Grade Tumors

Objective: To evaluate the efficacy of neurosurgical treatment of patients with drug-resistant structural epilepsy caused by low-grade brain tumors. Materials and Methods: 30 patients with drug-resistant structural epilepsy caused by low-grade tumors. Preoperative evaluation and surgical treatment were performed from 01.01.2016 to 31.12.2023. As a preoperative evaluation, all patients underwent neurological and neuropsychological examination, the semiology of seizures was assessed, and neuroimaging and neurophysiological studies were performed. A histological examination of resected brain areas was performed. Surgical outcome assessed by J. Engel Surgical Treatment Outcome Scale (1993) at 12, 24 months. Results: 30 patients were treated surgically, 10 (33%) were men and 20 (67%) – women. The mean age of the patients was 29.76 years. Focal motor and non-motor seizures were noted in 12 (40%) patients. 18 (60%) patients had bilateral tonic-clonic seizures with focal onset. All 30 patients underwent resection surgery: 10 patients (33%) underwent anterior mesial temporal lobectomy (AMTLE) , 17 patients (57%) – lesionectomy, 2 – AMTLE plus lesionectomy, and one – lesionectomy plus selective amygdalohippocampectomy (SAH). The results of surgical treatment 12 months after surgery were evaluated in 25 patients. Engel I outcomes after 12 months were in 18 patients (72%), at 24 months in - 73%. Conclusion: The results of our study demonstrate the efficacy of surgical treatment in patients with drug-resistant structural epilepsy caused by low-grade brain tumors. Significant improvement in seizure control was seen in the Engel I results at 12 and 24 months after surgery (72% and 73%, respectively