title: Epilepsy in cerebral glioma: timing of appearance and histological correlations.
abstract: OBJECTIVE
  A prospective study of patients with glioma was carried out. Special attention was paid to the first seizure, to the histology, and to the efficacy and prophylactic role of antiepileptic drugs (AEDs). Prognostic factors were analyzed.
  
  
  METHODS
  Between February 1st 2004 and April 1st 2006 patients who underwent surgical treatment at the Neurosurgery Department of Bolzano for primary or recurrent glioma were prospectively followed until April 1st 2007. Seizures at onset occurring in the absence of interictal epileptiform abnormalities were regarded as remote symptomatic seizures and not treated.
  
  
  RESULTS
  Sixty-four individuals were registered in the study; epilepsy diagnosis was made in 27 cases and in 24 of these seizures were the onset symptom. The correlation with histological grading showed that seizures were more frequent in low-grade glioma and in secondary glioblastoma. Although epilepsy was less frequent in high-grade glioma, in these patients seizures were more difficult to control. Poor seizure control was associated with motor and sensitive focal seizures and presence of neurological deficit. Patients without epilepsy and not taking AEDs never developed seizures during the follow-up.
  
  
  CONCLUSIONS
  Our study clearly shows that epilepsy is more frequent in low-grade gliomas but seizures are more difficult to control in high-grade gliomas. In both cases seizures are a quite exclusive symptom at the onset that never appears during the stable course of the disease. Amongst glioblastoma multiforme (GBM), epilepsy is more frequent in GBM developing through progression from low-grade astrocitoma. Moreover, our study strongly indicates that the prophylactic use of AEDs in glioma is not justified.
authors.affiliation: Neurology Clinic, University of Brescia, Italy. anna.rosati@libero.it
authors.forename: Anna
authors.initials: A
authors.lastname: Rosati
authors.forename: Alessia
authors.initials: A
authors.lastname: Tomassini
authors.forename: Bianca
authors.initials: B
authors.lastname: Pollo
authors.forename: Claudia
authors.initials: C
authors.lastname: Ambrosi
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwarz
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
authors.forename: Bruno
authors.initials: B
authors.lastname: Bonetti
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D004827:Epilepsy / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005910:Glioma / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D012640:Seizures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013995:Time
chemical_list: D000927:Anticonvulsants