PREVALENCE AND PROGNOSTIC-SIGNIFICANCE OF EPILEPSY IN PATIENTS WITH GLIOMAS

The aim of this study was to evaluate the prevalence and prognostic si gnificance of epilepsy in 1028 patients diagnosed in the computer tomo graphy (CT) era with histological low- or high-grade intracranial glio mas. Survival analysis included Kaplan-Meier plots, log-rank tests, lo gistic regression and Cox's analysis as implemented in the SPSS statis tical package. Epilepsy was a positive univariate (P<0.0001) and multi variate, (P<0.03) prognostic factor for survival in the total patient group (n = 1028, relative risk of death 0.83, 95% confidence interval (CI) 0.70-0.98) as well as in the high-grade patient group (n = 649, r elative risk of death 0.80, 95% CI 0.66-0.96), but not in the group of low-grade glioma patients (P > 0.2). The prevalence of epilepsy in gl ioblastoma patients was 251/512 (49%), 95/137 (69%) in anaplastic glio mas, and 322/379 (85%) in patients with low-grade gliomas, with 97 of the 102 T1 low-grade subgroup (95%) having epilepsy, indicating that t he presence of epilepsy may select patients for early radiological dia gnosis. The frequency of epilepsy at presentation decreased with age i n high-grade glioma patients, and increased with age in low-grade glio ma patients to a plateau in the fourth decade of Life (P<0.01). The pr evalence of epilepsy in patients with histological intracranial glioma s varied with patient age and tumour histology, with low-grade patient s having the highest prevalence. Epilepsy was a significant positive p rognostic factor except in patients with low-grade gliomas, and may se lect low-grade patients for early diagnosis. (C) 1998 Elsevier Science Ltd.