title: Seizures in low-grade gliomas: natural history, pathogenesis, and outcome after treatments.
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.
authors.affiliation: Department of Neuro-Oncology, University of Turin and San Giovanni Battista Hospital, Turin, Italy. rudarob@hotmail.com
authors.forename: Roberta
authors.initials: R
authors.lastname: Rudà
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bello
authors.forename: Hugues
authors.initials: H
authors.lastname: Duffau
authors.forename: Riccardo
authors.initials: R
authors.lastname: Soffietti
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology; D005910:Glioma / Q000150:complications* / Q000473:pathology; D006801:Humans; D060787:Neoplasm Grading; D012640:Seizures / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants