J Neurosurg 142:918–926, 2025
The study evaluates ECoG-nTMS–tailored supratotal resection (ETT-SpTR) for low-grade gliomas with epilepsy, demonstrating improved seizure control and preserved neurological function compared to gross-total resection. ETT-SpTR effectively identifies high-risk epilepsy areas, enhancing epileptic and functional outcomes without permanent deficits.
• Objective: Evaluate the effectiveness of ECoG-nTMS–tailored supratotal resection (ETT-SpTR) for low-grade gliomas (LGGs) in controlling seizures and preserving neurological function.
• Methods: Retrospective analysis of patients with LGG and epileptic seizures undergoing resective surgery, comparing gross-total resection (GTR) with ETT-SpTR.
• Results: ETT-SpTR significantly improved seizure control (85.7% Engel class IA) compared to GTR (25% Engel class IA) with no permanent neurological deficits.
• Conclusion: ETT-SpTR is effective in improving epileptic outcomes and preserving functions without causing permanent neurological worsening.
• Preoperative Techniques: Functional cortical areas were identified using TMS, and ECoG guided the removal of high-risk epilepsy areas (HREAs).
• Statistical Analysis: Significant differences in seizure control between groups, with ETT-SpTR showing better outcomes.
• Limitations: Small patient cohort and limited follow-up period; future studies required for confirmation.
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