ISSN 1300-7157 Anasayfa | İletişim      

Cilt : 27      Sayı : 3       Yıl: 2021

[Epilepsi]
Epilepsi. 2021; 27(3): 155-162 | DOI: 10.14744/epilepsi.2021.71676  

The Potential Effect of the IDH1 Mutation and MGMT Gene Promoter Methylation on the Control of Glioblastoma-Associated Epilepsy in Patients Receiving Anti-Epileptic Agents and Chemotherapies

Maher Kurdi1, Nadeem Shafique Butt2, Saleh Baeesa3, Badrah Alghamdi4, Yazid Maghrabi5, Anas Bardeesi5, Rothaina Saeedi3, Fahad Alghamdi6, Najla Alghanmi7, Mohammed Bari7, Alaa Samkari8, Ahmed Lary9, Taghreed Alsinani10, Sahar Hakamy11
1Department of Pathology, Faculty of Medicine in Rabigh, King Abdulaziz University, Kingdom of Saudi Arabia.
2Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
3Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
4Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
5Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.
6Department of Pathology, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
7Department of Pathology, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
8Department of Pathology and Laboratory Medicine, King Saud Bin Abdulaziz University for Health Science, Jeddah, Kingdom of Saudi Arabia.
9Section of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Jeddah, Kingdom of Saudi Arabia.
10Division of Neurosurgery, King Fahad General Hospital, Jeddah, Kingdom of Saudi Arabia.
11Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

INTRODUCTION: (a) To assess the control of seizure in glioblastoma patients receiving anti-epileptic drugs and chemotherapies after total resection and its association with O-methylguanine-DNA methyltransferase (MGMT) promoter methylation and the isocitrate dehydrogenase 1 (IDH1) mutation; (b) to determine which anti-epileptic drug exerts the best effective control on glioblastoma-associated epilepsy; (c) to identify the relationship between seizure control and anti-epileptic drugs with recurrence interval.
METHODS: This was a retrospective cohort study of patients with postoperative glioblastoma-associated epilepsy. The correlation between IDH1 mutation and MGMT methylation with anti-epileptic drugs, chemotherapy type, seizure control, and recurrence interval were analyzed.
RESULTS: The study included 53 patients with glioblastoma-associated epilepsy. IDH1 mutation was present in 20 patients, and MGMT methylation was present in 13 patients. 37 cases received chemoradiotherapy while 16 cases received only radiotherapy. Levetiracetam was the most prescribed anti-epileptic drug (n= 36, 60%), and 36 and 16 patients had controlled and uncontrolled seizures, respectively. IDH1 mutation and unmethylated MGMT were significantly present in cases with controlled epilepsy (P < 0.05). Levetiracetam showed significantly better seizure control in cases with IDH1 mutation and unmethylated MGMT promotor (P < 0.05).
DISCUSSION AND CONCLUSION: (a) Glioblastoma-associated epilepsy can be better controlled in patients with the IDH1 mutation and unmethylated MGMT, (b) Levetiracetam was the first-line anti-epileptic drug for controlling seizure, (c) Lack of seizure control in glioblastoma patients may not be related to tumor recurrence despite one-year treatment, (d) Better understanding of the risk factors associated with glioma-associated epilepsy are needed to improve patient quality of life.

Keywords: Glioblastoma, Epilepsy, MGMT promotor methylation, IDH1 mutation, Anti-epileptic drugs, Temozolomide


Maher Kurdi, Nadeem Shafique Butt, Saleh Baeesa, Badrah Alghamdi, Yazid Maghrabi, Anas Bardeesi, Rothaina Saeedi, Fahad Alghamdi, Najla Alghanmi, Mohammed Bari, Alaa Samkari, Ahmed Lary, Taghreed Alsinani, Sahar Hakamy. The Potential Effect of the IDH1 Mutation and MGMT Gene Promoter Methylation on the Control of Glioblastoma-Associated Epilepsy in Patients Receiving Anti-Epileptic Agents and Chemotherapies. Epilepsi. 2021; 27(3): 155-162

Sorumlu Yazar: Maher Kurdi, Saudi Arabia


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