title: Predictors and mechanisms of epilepsy occurrence in cerebral gliomas: What to look for in clinicopathology.
abstract: Gliomas, especially low-grade gliomas, are highly epileptogenic brain tumors. Histopathological information is valuable in evaluating the diagnosis and/or biologic behavior of various gliomas. Here we explored the clinical data and histopathological predictors of the occurrence of epilepsy in patients with gliomas. A retrospective study examined 310 consecutive patients who had undergone surgical treatment for gliomas in our institution from January 2013 to January 2015. Clinical data and pathological examination results were analyzed. Literatures regarding the predictors and etiology of glioma associated epileptic seizures in the period of 1995-2015 were also reviewed. A total of 234 (75.5%) astrocytic tumors and 76 (24.5%) oligodendrial tumors were included. At diagnosis, 33.6% of patients had epileptic seizures. Multivariate analysis revealed cortex involvement (OR=7.991, 95%CI=1.599-39.926), lower World Health Organization grade (OR=3.584, 95%CI=1.032-12.346) and topoisomerase II (TopoII) positivity (OR=0.943, 95%CI=0.903-0.982) were strong predictors for preoperative epileptic seizures. Gender, disease course, tumor classification, location or volume did not significantly affect epileptic seizure occurrence. Forty-three publications involved glioma-associated epilepsy were found in PubMed online database and key data were extracted and summarized. The present studies on glioma-related epilepsy are relatively limited and inconsistent. Low-grade gliomas, cortex involvement and TopoII positivity were independent predictors of a history of epileptic seizures at diagnosis. Further studies to examine the underlying mechanism of topoisomerase II as well as other molecules in epilepsy occurrence in brain gliomas are needed in the future.
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China; Rehabilitation Medicine Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China.
authors.forename: Xiao-Sa
authors.initials: XS
authors.lastname: Chi
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China.
authors.forename: Ni
authors.initials: N
authors.lastname: Chen
authors.affiliation: Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China. Electronic address: jinmei-neuro@qq.com.
authors.forename: Jin-Mei
authors.initials: JM
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000378:metabolism / Q000473:pathology; D001932:Brain Neoplasms / Q000201:enzymology / Q000453:epidemiology* / Q000601:surgery; D002648:Child; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D004250:DNA Topoisomerases, Type II / Q000378:metabolism*; D004827:Epilepsy / Q000201:enzymology / Q000453:epidemiology*; D005260:Female; D005910:Glioma / Q000201:enzymology / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004250:DNA Topoisomerases, Type II
keywords: Brain tumor; DNA topoisomerase; Epilepsy; Neurobiology; Pathology