Highlights
- •Gliomas are a common primary brain tumor; epilepsy is a frequent manifestation.
- •Seizure pathogenesis relates to unique molecular, genetic, and structural factors.
- •Genetic discovery in glioma research may assist with seizure control.
- •Surgery geared toward epileptogenic zone resection may be necessary for control.
- •Questions regarding the utility of prophylactic anticonvulsant therapy remain.
Abstract
Gliomas are fatal brain tumors, and even low-grade gliomas (LGGs) have an average
survival of less than a decade. Seizures are a common presentation of gliomas, particularly
LGGs, and substantially impact quality of life. Glioma-related seizures differ from
other focal epilepsies in their pathogenesis and in the likelihood of refractory epilepsy.
We review factors that predict seizure activity and response to treatment, optimal
pharmacologic and surgical management of glioma-related epilepsy, and the benefit
of using newer anti-seizure medications in patients with gliomas. As surgery is so
often beneficial with seizure reduction, we discuss oncologic and epilepsy surgery
perspectives. Treatment of gliomas has the potential to ameliorate seizures and increase
rates of seizure freedom. Prospective, well-powered studies are needed to provide
more definitive answers for practitioners taking care of glioma patients with seizures.
Keywords
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Article info
Publication history
Published online: July 19, 2019
Accepted:
July 18,
2019
Received in revised form:
June 24,
2019
Received:
May 10,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
