Primary brain tumor clinical features [Neurosurgery Wiki]

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====== Primary brain tumor clinical features ======

An [[epileptic seizure]] is the most common clinical [[manifestation]] of a primary [[brain tumor]] and responsible for its diagnosis in 30–50% of cases 
((van Breemen MS, Wilms EB, Vecht CJ. Epilepsy in patients with brain tumours:
epidemiology, mechanisms, and management. Lancet Neurol. 2007 May;6(5):421-30.
Review. PubMed PMID: 17434097.
)).
Due to modern [[neuroimaging]], detailed anatomical information on a brain tumor is available early in the diagnostic process and therefore carries considerable potential in [[clinical decision-making]]. The [[goal]] of a study of Akeret et al., was to gain a better understanding of the [[relevance]] of anatomical [[tumor]] characteristics on [[seizure]] [[prevalence]] and [[semiology]].

They [[review]]ed [[prospective]]ly collected clinical and [[imaging]] [[data]] of all patients operated on a [[supratentorial]] intraparenchymal primary brain tumor at the Neuroscience Center [[Zurich]] between January 2009 and December 2016. The effect of tumor [[histology]], anatomical location and [[white matter]] [[infiltration]] on seizure [[prevalence]] and [[semiology]] were assessed using uni- and [[multivariate]] analyses.

Of 678 included patients, 311 (45.9%) presented with epileptic seizures. Tumor location within the [[central lobe]] was associated with higher seizure prevalence (OR 4.67, 95% CI: 1.90-13.3, p = .002), especially within the [[precentral gyrus]] or [[paracentral lobule]] (100%). Bilateral extension, location within [[subcortical]] structures and invasion of deeper white matter sectors were associated with a lower risk (OR 0.45, 95% CI: 0.25-0.78; OR 0.10, 95% CI: 0.04-0.21 and OR 0.39, 95% CI: 0.14-0.96, respectively). Multivariate analysis revealed the [[impact]] of a [[location]] within the central lobe on seizure risk to be highly significant and more relevant than histopathology (OR: 4.79, 95% CI: 1.82-14.52, p = .003). Seizures due to tumors within the [[central lobe]] differed from those of other locations by lower risk of secondary generalization (p < .001).

Topographical lobar and gyral location, as well as the extent of white matter infiltration impact seizure risk and semiology. This finding may have a high therapeutic potential, for example regarding the use of prophylactic [[antiepileptic]] therapy
((Akeret K, Serra C, Rafi O, Staartjes VE, Fierstra J, Bellut D, Maldaner N,
Imbach LL, Wolpert F, Poryazova R, Regli L, Krayenbühl N. Anatomical features of 
primary brain tumors affect seizure risk and semiology. Neuroimage Clin. 2019 Jan
25;22:101688. doi: 10.1016/j.nicl.2019.101688. [Epub ahead of print] PubMed PMID:
30710869.
)).

===== References =====