Seizures in low-grade gliomas: Natural history, pathogenesis, and outcome after treatments

Roberta Rudà, Lorenzo Bello, Hugues Duffau, Riccardo Soffietti

Research output: Contribution to journalArticle

Abstract

Seizures represent a common symptom in low-grade gliomas; when uncontrolled, they significantly contribute to patient morbidity and negatively impact quality of life. Tumor location and histology influence the risk for epilepsy. The pathogenesis of tumor-related epilepsy is multifactorial and may differ among tumor histologies (glioneuronal tumors vs diffuse grade II gliomas). Gross total resection is the strongest predictor of seizure freedom in addition to clinical factors, such as preoperative seizure duration, type, and control with antiepileptic drugs (AEDs). Epilepsy surgery may improve seizure control. Radiotherapy and chemotherapy with alkylating agents (procarbazine CCNU vincristine, temozolomide) are effective in reducing the frequency of seizures in patients with pharmacoresistant epilepsy. Newer AEDs (levetiracetam, topiramate, lacosamide) seem to be better tolerated than the old AEDs (phenobarbital, phenytoin, carbamazepine), but there is lack of evidence regarding their superiority in terms of efficacy.

Original languageEnglish
JournalNeuro-Oncology
Volume14
Issue numberSUPPL.4
DOIs
Publication statusPublished - Sep 2012

Keywords

  • antiepileptic drugs
  • chemotherapy
  • diffuse gliomas
  • epileptogenesis
  • glioneuronal tumors
  • radiotherapy
  • seizures
  • surgery

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Clinical Neurology

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