Postoperative seizure control in glioma patients with epilepsy

Gliomas account for approximately 80% of all primary malignant brain tumors with a rate of 2–8 cases per 100,000 person-years. Gliomas result in a disproportionate share of cancer morbidity, including focal neurological deficits, cognitive impairment and seizures. Seizures may occur in every type of glioma, although the epileptogenicity of gliomas tends to be inversely correlated to the growth rate of the tumor (1). Approximately 70–90% of all patients with low-grade glioma (LGG) develop epilepsy during the course of the disease, in comparison to 30–60% of patients with high-grade glioma (HGG) (2). Gliomas located in the frontal or temporal lobe, as well as cortical located tumors tend to be more epileptogenic (1). In the clinical management of gliomas it is of major importance to achieve seizure control, as seizures may negatively influence health-related quality of life and cause cognitive disturbances, particularly when uncontrolled (3). In spite of using multiple antiepileptic drugs (AEDs), about one third of low-grade glioma patients will not become seizure free (4).