Skip to main content
SpringerLink
Log in

What is New in the Management of Epilepsy in Gliomas?

  • Neuro-oncology (R Soffietti, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Opinion statement

Seizures represent a common symptom in low- and high-grade gliomas. Tumor location and histology influence the risk for epilepsy. Some molecular factors (BRAF V 600E mutations in glioneuronal tumors and IDH1/2 mutations in diffuse grade II and III gliomas) are molecular factors that are relevant for diagnosis and prognosis and have been associated with the risk of epilepsy as well. Glutamate plays a central role in epileptogenicity and growth of glial and glioneuronal tumors, based on the release of glutamate from tumor cells that enhances excitotoxicity, and a downregulation of the inhibitory GABAergic pathways. Several potential targets for therapy have been identified, and m-TOR inhibitors have already shown activity. 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). 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 (in particular levetiracetam and lacosamide) seem to be better tolerated than the old AEDs (phenobarbital, phenytoin, carbamazepine), but randomized clinical trials are needed to prove their superiority in terms of efficacy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rudà R, Trevisan E, Soffietti R. Epilepsy and brain tumors. Curr Opin Oncol. 2010;22(6):611–20.

    Article  PubMed  Google Scholar 

  2. Klein M, Engelberts NH, van der Ploeg HM, Kasteleijn-Nolst Trenité DG, Aaronson NK, Taphoorn MJ, et al. Epilepsy in low-grade gliomas: the impact on cognitive function and quality of life. Ann Neurol. 2003;54(4):514–20.

    Article  PubMed  Google Scholar 

  3. Duffau H, Capelle L, Lopes M, Bitar A, Sichez JP, van Effenterre R. Medically intractable epilepsy from insular low-grade gliomas: improvement after an extended lesionectomy. Acta Neurochir (Wien). 2002;144(6):563–72. discussion 572–73.

    Article  CAS  Google Scholar 

  4. Luyken C, Blümcke I, Fimmers R, Urbach H, Elger CE, Wiestler OD, et al. The spectrum of long-term epilepsy-associated tumors: long-term seizure and tumor outcome and neurosurgical aspects. Epilepsia. 2003;44(6):822–30.

    Article  PubMed  Google Scholar 

  5. Chang EF, Potts MB, Keles GE, Lamborn KR, Chang SM, Barbaro NM, et al. Seizure characteristics and control following resection in 332 patients with low-grade gliomas. J Neurosurg. 2008;108(2):227–35.

    Article  PubMed  Google Scholar 

  6. Pallud J, Audureau E, Blonski M, Sanai N, Bauchet L, Fontaine D, et al. Epileptic seizures in diffuse low-grade gliomas in adults. Brain. 2014;137(Pt2):449–62. The largest dataset on low grade gliomas with important information regarding prognostic factors.

    Article  PubMed  Google Scholar 

  7. Thom M, Blümcke I, Aronica E. Long-term epilepsy-associated tumors. Brain Pathol. 2012;22(3):350–79.

    Article  PubMed  Google Scholar 

  8. Compton JJ, Laack NN, Eckel LJ, Schomas DA, Giannini C, Meyer FB. Long-term outcomes for low-grade intracranial ganglioglioma: 30-year experience from the Mayo Clinic. J Neurosurg. 2012;117(5):825–30.

    Article  PubMed  Google Scholar 

  9. Southwell DG, Garcia PA, Berger MS, Barbaro NM, Chang EF. Long-term seizure control outcomes after resection of gangliogliomas. Neurosurgery. 2012;70(6):1406–13.

    Article  PubMed  Google Scholar 

  10. Japp A, Gielen GH, Becker AJ. Recent aspects of classification and epidemiology of epilepsy-associated tumors. Epilepsia. 2013;54 Suppl 9:5–11.

    Article  PubMed  Google Scholar 

  11. Kerkhof M, Vecht CJ. Seizure characteristics and prognostic factors of gliomas. Epilepsia. 2013;54 Suppl 9:12–7. A thorough review of seizure types and prognostic factors in glioneuronal tumors and diffuse gliomas.

    Article  PubMed  Google Scholar 

  12. Selvanathan SK, Hammouche S, Salminen HJ, Jenkinson MD. Outcome and prognostic features in anaplastic ganglioglioma: analysis of cases from the SEER database. J Neuro-Oncol. 2011;105(3):539–45.

    Article  Google Scholar 

  13. Schindler G, Capper D, Meyer J, Janzarik W, Omran H, Herold-Mende C, et al. Analysis of BRAF V600E mutation in 1,320 nervous system tumors reveals high mutation frequencies in pleomorphic xanthoastrocytoma, ganglioglioma and extra-cerebellar pilocytic astrocytoma. Acta Neuropathol. 2011;121(3):397–405.

    Article  CAS  PubMed  Google Scholar 

  14. Chappé C, Padovani L, Scavarda D, Forest F, Nanni-Metellus I, Loundou A, et al. Dysembryoplastic neuroepithelial tumors share with pleomorphic xanthoastrocytomas and gangliogliomas BRAF(V600E) mutation and expression. Brain Pathol. 2013;23(5):574–83.

    Article  PubMed  Google Scholar 

  15. Koelsche C, Wöhrer A, Jeibmann A, Schittenhelm J, Schindler G, Preusser M, et al. Mutant BRAF V600E protein in ganglioglioma is predominantly expressed by neuronal tumor cells. Acta Neuropathol. 2013;125(6):891–900.

    Article  CAS  PubMed  Google Scholar 

  16. Prabowo AS, Iyer AM, Veersema TJ, Anink JJ, Schouten-van Meeteren AY, Spliet WG, et al. BRAF V600E mutation is associated with mTOR signaling activation in glioneuronal tumors. Brain Pathol. 2014;24(1):52–66. The largest series investigating BRAF V600 mutation in gangliogliomas and dysembryoplastic neuroepithelial tumors.

    Article  CAS  PubMed  Google Scholar 

  17. Prayson RA. Diagnostic challenges in the evaluation of chronic epilepsy-related surgical neuropathology. Am J Surg Pathol. 2010;34(5):e1–13.

    Article  PubMed  Google Scholar 

  18. Marucci G, de Biase D, Visani M, Giulioni M, Martinoni M, Volpi L, et al. Mutant BRAF in low-grade epilepsy-associated tumors and focal cortical dysplasia. Ann Clin Transl Neurol. 2014;1(2):130–4. The first preliminary report of the presence of BRAF V 600 mutation in cortical dysplasias associated with glioneuronal tumors.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Blümcke I, Wiestler OD. Gangliogliomas: an intriguing tumor entity associated with focal epilepsies. J Neuropathol Exp Neurol. 2002;61(7):575–84.

    PubMed  Google Scholar 

  20. Iuchi T, Hasegawa Y, Kawasaki K, Sakaida T. Epilepsy in patients with gliomas: incidence and control of seizures. J Clin Neurosci. 2015;22(1):87–91.

    Article  PubMed  Google Scholar 

  21. You G, Sha ZY, Yan W, Zhang W, Wang YZ, Li SW, et al. Seizure characteristics and outcomes in 508 Chinese adult patients undergoing primary resection of low-grade gliomas: a clinicopathological study. Neuro Oncology. 2012;14(2):230–41.

    Article  PubMed Central  PubMed  Google Scholar 

  22. DeSilva TM, Borenstein NS, Volpe JJ, Kinney HC, Rosenberg PA. Expression of EAAT2 in neurons and protoplasmic astrocytes during human cortical development. J Comp Neurol. 2012;520(17):3912–32.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Schramm J, Luyken C, Urbach H, Fimmers R, Blümcke I. Evidence for a clinically distinct new subtype of grade II astrocytomas in patients with long-term epilepsy. Neurosurgery. 2004;55(2):340–7.

    Article  PubMed  Google Scholar 

  24. Korshunov A, Meyer J, Capper D, Christians A, Remke M, Witt H, et al. Combined molecular analysis of BRAF and IDH1 distinguishes pilocytic astrocytoma from diffuse astrocytoma. Acta Neuropathol. 2009;118(3):401–5.

    Article  CAS  PubMed  Google Scholar 

  25. Stockhammer F, Misch M, Helms HJ, et al. IDH1/2 mutations in WHO grade II astrocytomas associated with localization and seizure as the initial symptom. Seizure. 2012;21(3):194–7. The first paper suggesting an association between IDH1/2 mutation and onset with seizures in grade II astrocytomas.

    Article  PubMed  Google Scholar 

  26. Liubinas SV, D’Abaco GM, Moffat BM, et al. IDH1 mutation is associated with seizures and protoplasmic subtype in patients with low-grade gliomas. Epilepsia. 2014;55(9):1438–43.

    Article  CAS  PubMed  Google Scholar 

  27. Zhong Z, Wang Z, Wang Y, et al. IDH1/2 mutation is associated with seizure as an initial symptom in low-grade glioma: a report of 311 Chinese adult glioma patients. Epilepsy Res. 2015;109:100–5.

    Article  CAS  PubMed  Google Scholar 

  28. Kolker S, Pawlak V, Ahlemeyer B, et al. NMDA receptor activation and respiratory chain complex V inhibition contribute to neurodegeneration in d-2-hydroxyglutaric aciduria. Eur J Neurosci. 2002;16:21–8.

    Article  PubMed  Google Scholar 

  29. Craigen WJ, Jakobs C, Sekul EA, et al. d-2-hydroxyglutaric aciduria in neonate with seizures and CNS dysfunction. Pediatr Neurol. 1994;10:49–53.

    Article  CAS  PubMed  Google Scholar 

  30. Huang L, You G, Jiang T, et al. Correlation between tumor-related seizures and molecular genetic profile in 103 Chinese patients with low-grade gliomas: a preliminary study. J Neurol Sci. 2011;302(1–2):63–7.

    Article  CAS  PubMed  Google Scholar 

  31. Chi AS, Batchelor TT, Yang D, et al. BRAF V600E mutation identifies a subset of low-grade diffusely infiltrating gliomas in adults. J Clin Oncol. 2013;31:233–6.

    Article  Google Scholar 

  32. Lee JW, Norden AD, Ligon KL, Golby AJ, Beroukhim R, Quackenbush J, et al. Tumor associated seizures in glioblastomas are influenced by survival gene expression in a region-specific manner: a gene expression imaging study. Epilepsy Res. 2014;108(5):843–52.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Lee JW, Wen PY, Hurwitz S, Black P, Kesari S, Drappatz J, et al. Morphological characteristics of brain tumors causing seizures. Arch Neurol. 2010;67(3):336–42.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Stark AM, van de Bergh J, Hedderich J, Mehdorn HM, Nabavi A. Glioblastoma: clinical characteristics, prognostic factors and survival in 492 patients. Clin Neurol Neurosurg. 2012;114(7):840–5.

    Article  PubMed  Google Scholar 

  35. Capelle L, Fontaine D, Mandonnet E, Taillandier L, Golmard JL, Bauchet L, et al. Spontaneous and therapeutic prognostic factors in adult hemispheric World Health Organization Grade II gliomas: a series of 1097 cases: clinical article. J Neurosurg. 2013;118(6):1157–68.

    Article  PubMed  Google Scholar 

  36. Yang P, You G, Zhang W, Wang Y, Wang Y, Yao K, et al. Correlation of preoperative seizures with clinicopathological factors and prognosis in anaplastic gliomas: a report of 198 patients from China. Seizure. 2014;23(10):844–51.

    Article  PubMed  Google Scholar 

  37. Chaichana KL, Parker SL, Olivi A, Quiñones-Hinojosa A. Long-term seizure outcomes in adult patients undergoing primary resection of malignant brain astrocytomas. Clinical article. J Neurosurg. 2009;111(2):282–92.

    Article  PubMed  Google Scholar 

  38. de Groot J, Sontheimer H. Glutamate and the biology of gliomas. Glia. 2011;59(8):1181–9.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Liubinas SV, O’Brien TJ, Moffat BM, Drummond KJ, Morokoff AP, Kaye AH. Tumour associated epilepsy and glutamate excitotoxicity in patients with gliomas. J Clin Neurosci. 2014;21(6):899–908. A thorough review of a role of glutamate in tumor-associated epilepsy.

    Article  CAS  PubMed  Google Scholar 

  40. Ye ZC, Sontheimer H. Glioma cells release excitotoxic concentrations of glutamate. Cancer Res. 1999;59(17):4383–91.

    CAS  PubMed  Google Scholar 

  41. Yuen TI, Morokoff AP, Bjorksten A, D’Abaco G, Paradiso L, Finch S, et al. Glutamate is associated with a higher risk of seizures in patients with gliomas. Neurology. 2012;79(9):883–9. The first report of the importance of glutamate in relation with seizures in patients with gliomas.

    Article  CAS  PubMed  Google Scholar 

  42. Buckingham SC, Campbell SL, Haas BR, Montana V, Robel S, Ogunrinu T, et al. Glutamate release by primary brain tumors induces epileptic activity. Nat Med. 2011;17(10):1269–74.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  43. Robe PA, Martin DH, Nguyen-Khac MT, Artesi M, Deprez M, Albert A, et al. Early termination of ISRCTN45828668, a phase 1/2 prospective, randomized study of sulfasalazine for the treatment of progressing malignant gliomas in adults. BMC Cancer. 2009;9:372.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Seltzer MJ, Bennett BD, Joshi AD, Gao P, Thomas AG, Ferraris DV, et al. Inhibition of glutaminase preferentially slows growth of glioma cells with mutant IDH1. Cancer Res. 2010;70(22):8981–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  45. Yao PS, Kang DZ, Lin RY, Ye B, Wang W, Ye ZC. Glutamate/glutamine metabolism coupling between astrocytes and glioma cells: neuroprotection and inhibition of glioma growth. Biochem Biophys Res Commun. 2014;450(1):295–9.

    Article  CAS  PubMed  Google Scholar 

  46. Ching J, Amiridis S, Stylli SS, Morokoff AP, O’Brien TJ, Kaye AH. A novel treatment strategy for glioblastoma multiforme and glioma associated seizures: increasing glutamate uptake with PPARγ agonists. J Clin Neurosci. 2015;22(1):21–8.

    Article  CAS  PubMed  Google Scholar 

  47. Prakash O, Lukiw WJ, Peruzzi F, Reiss K, Musto AE. Gliomas and seizures. Med Hypotheses. 2012;79(5):622–6.

    Article  CAS  PubMed  Google Scholar 

  48. Rosati A, Marconi S, Pollo B, Tomassini A, Lovato L, Maderna E, et al. Epilepsy in glioblastoma multiforme: correlation with glutamine synthetase levels. J Neuro-Oncol. 2009;93(3):319–24.

    Article  CAS  Google Scholar 

  49. Aronica E, Yankaya B, Jansen GH, Leenstra S, van Veelen CW, Gorter JA, et al. Ionotropic and metabotropic glutamate receptor protein expression in glioneuronal tumours from patients with intractable epilepsy. Neuropathol Appl Neurobiol. 2001;27(3):223–37.

    Article  CAS  PubMed  Google Scholar 

  50. Aronica E, Gorter JA, Ijlst-Keizers H, Rozemuller AJ, Yankaya B, Leenstra S, et al. Expression and functional role of mGluR3 and mGluR5 in human astrocytes and glioma cells: opposite regulation of glutamate transporter proteins. Eur J Neurosci. 2003;17(10):2106–18.

    Article  PubMed  Google Scholar 

  51. van Vuurden DG, Yazdani M, Bosma I, Broekhuizen AJ, Postma TJ, Heimans JJ, et al. J. Attenuated AMPA receptor expression allows glioblastoma cell survival in glutamate-rich environment. PLoS ONE. 2009;4(6), e5953.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Grossman SA, Ye X, Chamberlain M, Mikkelsen T, Batchelor T, Desideri S, et al. Talampanel with standard radiation and temozolomide in patients with newly diagnosed glioblastoma: a multicenter phase II trial. J Clin Oncol. 2009;27(25):4155–61.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  53. Iwamoto FM, Kreisl TN, Kim L, Duic JP, Butman JA, Albert PS, et al. Phase 2 trial of talampanel, a glutamate receptor inhibitor, for adults with recurrent malignant gliomas. Cancer. 2010;116(7):1776–82.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  54. Campbell SL, Robel S, Cuddapah VA, Robert S, Buckingham SC, Kahle KT, et al. GABAergic disinhibition and impaired KCC2 cotransporter activity underlie tumor-associated epilepsy. Glia. 2015;63(1):23–36. A pivotal paper demonstrating the importance of GABAergic pathway impairment in tumor-associated epilepsy.

    Article  PubMed  Google Scholar 

  55. Samadani U, Judkins AR, Akpalu A, Aronica E, Crino PB. Differential cellular gene expression in ganglioglioma. Epilepsia. 2007;48(4):646–53.

    Article  CAS  PubMed  Google Scholar 

  56. Boer K, Troost D, Timmermans W, van Rijen PC, Spliet WG, Aronica E. Pi3K-mTOR signaling andAMOG expression in epilepsy-associated glioneuronal tumors. Brain Pathol. 2010;20:234–44.

    Article  CAS  PubMed  Google Scholar 

  57. Rodriguez EF, Scheithauer BW, Giannini C, et al. PI3K/AKT pathway alterations are associated with clinically aggressive and histologically anaplastic subsets of pilocytic astrocytoma. Acta Neuropathol. 2011;121:407–20.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  58. McBride SM, Perez DA, Polley MY, Vandenberg SR, Smith JS, Zheng S, et al. Activation of PI3K/mTOR pathway occurs in most adult low-grade gliomas and predicts patient survival. J Neuro-Oncol. 2010;97(1):33–40.

    Article  CAS  Google Scholar 

  59. Wong M. A critical review of mTOR inhibitors and epilepsy: from basic science to clinical trials. Expert Rev Neurother. 2013;13(6):657–69. An interesting review of the role of m-TOR pathway in epilepsy.

    Article  CAS  PubMed  Google Scholar 

  60. Krueger DA, Wilfong AA, Holland-Bouley K, Anderson AE, Agricola K, Tudor C, et al. Everolimus treatment of refractory epilepsy in tuberous sclerosis complex. Ann Neurol. 2013;74(5):679–87. An important paper reporting the efficacy of an m-TOR inhibitor on seizures in tuberous sclerosis regardless of the effect on growth of SEGAS.

    Article  CAS  PubMed  Google Scholar 

  61. Cardamone M, Flanagan D, Mowat D, Kennedy SE, Chopra M, Lawson JA. Mammalian target of rapamycin inhibitors for intractable epilepsy and subependymal giant cell astrocytomas in tuberous sclerosis complex. J Pediatr. 2014;164(5):1195–200.

    Article  CAS  PubMed  Google Scholar 

  62. Gu W, Brodtkorb E, Piepoli T, Finocchiaro G, Steinlein OK. LGI1: a gene involved in epileptogenesis and glioma progression? Neurogenetics. 2005;6(2):59–66.

    Article  CAS  PubMed  Google Scholar 

  63. Rudà R, Bello L, Duffau H, Soffietti R. Seizures in low-grade gliomas: natural history, pathogenesis, and outcome after treatments. Neuro Oncology. 2012;14 Suppl 4:iv55–64.

    Article  PubMed Central  PubMed  Google Scholar 

  64. de Groot M, Reijneveld JC, Aronica E, Heimans JJ. Epilepsy in patients with a brain tumour: focal epilepsy requires focused treatment. Brain. 2012;135(Pt4):1002–16.

    Article  PubMed  Google Scholar 

  65. Maurice C, Mason WP. Seizure management in patients with gliomas. Expert Rev Neurother. 2014;14(4):367–77.

    Article  CAS  PubMed  Google Scholar 

  66. Vecht CJ, Kerkhof M, Duran-Pena A. Seizure prognosis in brain tumors: new insights and evidence-based management. Oncologist. 2014;19(7):751–9. An updated review on the impact of AEDs on seizures in brain tumors.

    Article  CAS  PubMed  Google Scholar 

  67. Englot DJ, Berger MS, Barbaro NM, Chang EF. Factors associated with seizure freedom in the surgical resection of glioneuronal tumors. Epilepsia. 2012;53(1):51–7.

    Article  PubMed  Google Scholar 

  68. Englot DJ, Han SJ, Berger MS, Barbaro NM, Chang EF. Extent of surgical resection predicts seizure freedom in low-grade temporal lobe brain tumors. Neurosurgery. 2012;70(4):921–8. discussion 928.

    Article  PubMed  Google Scholar 

  69. Shinoda J, Yokoyama K, Miwa K, Ito T, Asano Y, Yonezawa S, et al. Epilepsy surgery of dysembryoplastic neuroepithelial tumors using advanced multitechnologies with combined neuroimaging and electrophysiological examinations. Epilepsy Behav Case Rep. 2013;1:97–105.

    Article  PubMed Central  PubMed  Google Scholar 

  70. Englot DJ, Berger MS, Barbaro NM, Chang EF. Predictors of seizure freedom after resection of supratentorial low-grade gliomas. A review. J Neurosurg. 2011;115(2):240–4.

    Article  PubMed  Google Scholar 

  71. Smith VL. Resection strategies in tumoral epilepsy: is a lesionectomy enough? Epilepsia. 2013;54(Suppl9):72–8.

    Google Scholar 

  72. Ius T, Pauletto G, Isola M, Gregoraci G, Budai R, Lettieri C, et al. Surgery for insular low-grade glioma: predictors of postoperative seizure outcome. J Neurosurg. 2014;120(1):12–23. A large series of insular tumor with intractable epilepsy treated with surgery.

    Article  PubMed  Google Scholar 

  73. Kim YH, Park CK, Kim TM, Choi SH, Kim YJ, Choi BS, et al. Seizures during the management of high-grade gliomas: clinical relevance to disease progression. J Neuro-Oncol. 2013;113(1):101–9.

    Article  Google Scholar 

  74. Kemerdere R, Yuksel O, Kacira T, Yeni N, Ozkara C, Tanriverdi T, et al. Low-grade temporal gliomas: surgical strategy and long-term seizure outcome. Clin Neurol Neurosurg. 2014;126:196–200. A paper discussing the discontinuation of AEDs following surgery.

    Article  PubMed  Google Scholar 

  75. Nossek E, Matot I, Shahar T, Barzilai O, Rapoport Y, Gonen T, et al. Intraoperative seizures during awake craniotomy: incidence and consequences: analysis of 477 patients. Neurosurgery. 2013;73(1):135–40. discussion 140.

    Article  PubMed  Google Scholar 

  76. Deras P, Moulinié G, Maldonado IL, Moritz-Gasser S, Duffau H, Bertram L. Intermittent general anesthesia with controlled ventilation for asleep-awake-asleep brain surgery: a prospective series of 140 gliomas in eloquent areas. Neurosurgery. 2012;71(4):764–71.

    Article  PubMed  Google Scholar 

  77. de Oliveira Lima GL, Duffau H. Is there a risk of seizures in “preventive” awake surgery for incidental diffuse low-grade gliomas? J Neurosurg. 2015;27:1–9. [Epub ahead of print]. A paper reporting new data on the risk of seizures during awake surgery.

    Article  Google Scholar 

  78. Gonen T, Grossman R, Sitt R, Nossek E, Yanaki R, Cagnano E, et al. Tumor location and IDH1 mutation may predict intraoperative seizures during awake craniotomy. J Neurosurg. 2014;121(5):1133–8. A paper demonstrating the association of risk of intraoperative seizures with tumor location and a molecular factor.

    Article  PubMed  Google Scholar 

  79. Hu WH, Ge M, Zhang K, Meng FG, Zhang JG. Seizure outcome with surgical management of epileptogenic ganglioglioma: a study of 55 patients. Acta Neurochir (Wien). 2012;154(5):855–61.

    Article  Google Scholar 

  80. Hamer HM, Hong SB. Is an epilepsy presurgical evaluation necessary for mid-grade and high-grade brain tumors presenting with seizures? Epilepsia. 2013;54 Suppl 9:56–60.

    Article  PubMed  Google Scholar 

  81. Rudà R, Magliola U, Bertero L, Trevisan E, Bosa C, Mantovani C, et al. Seizure control following radiotherapy in patients with diffuse gliomas: a retrospective study. Neuro Oncology. 2013;15(12):1739–49. The first paper reporting the efficacy of conventional radiation on seizures in a homogeneous cohort of glioma patients.

    Article  PubMed Central  PubMed  Google Scholar 

  82. Koekkoek JA, Dirven L, Heimans JJ, Postma TJ, Vos MJ, Reijneveld JC, et al. Seizure reduction in a low-grade glioma: more than a beneficial side effect of temozolomide. J Neurol Neurosurg Psychiatry. 2015;86(4):366–73. An interesting study suggesting the prognostic importance of seizure reduction following chemotherapy with temozolomide.

    Article  PubMed  Google Scholar 

  83. Rees J. Temozolomide in low-grade gliomas: living longer and better. J Neurol Neurosurg Psychiatry. 2015;86(4):359–60.

    Article  PubMed  Google Scholar 

  84. Glauser T, Ben-Menachem E, Bourgeois B, Cnaan A, Guerreiro C, Kälviäinen R, et al. ILAE Subcommission on AED Guidelines. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia. 2013;54(3):551–63.

    Article  CAS  PubMed  Google Scholar 

  85. Kerrigan S, Grant R. Antiepileptic drugs for treating seizures in adults with brain tumours. Cochrane Database Syst Rev. 2011;8:CD008586.

    PubMed  Google Scholar 

  86. Bähr O, Hermisson M, Rona S, Rieger J, Nussbaum S, Körtvelyessy P, et al. Intravenous and oral levetiracetam in patients with a suspected primary brain tumor and symptomatic seizures undergoing neurosurgery: the HELLO trial. Acta Neurochir (Wien). 2012;154(2):229–35. discussion 235.

    Article  Google Scholar 

  87. Bodalia PN, Grosso AM, Sofat R, Macallister RJ, Smeeth L, Dhillon S, et al. Comparative efficacy and tolerability of anti-epileptic drugs for refractory focal epilepsy: systematic review and network meta-analysis reveals the need for long term comparator trials. Br J Clin Pharmacol. 2013;76(5):649–67.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  88. Perucca E. Optimizing antiepileptic drug treatment in tumoral epilepsy. Epilepsia. 2013;54 Suppl 9:97–104.

    Article  CAS  PubMed  Google Scholar 

  89. Rossetti AO, Jeckelmann S, Novy J, Roth P, Weller M, Stupp R. Levetiracetam and pregabalin for antiepileptic monotherapy in patients with primary brain tumors. A phase II randomized study. Neuro-Oncology. 2014;16(4):584–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  90. Kerkhof M, Dielemans JC, van Breemen MS, Zwinkels H, Walchenbach R, Taphoorn MJ, et al. Effect of valproic acid on seizure control and on survival in patients with glioblastoma multiforme. Neuro Oncology. 2013;15(7):961–7. A study reporting the impact of valproate and levetiracetam on seizures in patients with glioblastoma.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  91. Simó M, Velasco R, Graus F, Verger E, Gil M, Pineda E, et al. Impact of antiepileptic drugs on thrombocytopenia in glioblastoma patients treated with standard chemoradiotherapy. J Neuro-Oncol. 2012;108(3):451–8.

    Article  Google Scholar 

  92. Tinchon A, Oberndorfer S, Marosi C, Gleiss A, Geroldinger A, Sax C, et al. Haematological toxicity of valproic acid compared to levetiracetam in patients with glioblastoma multiforme undergoing concomitant radio-chemotherapy: a retrospective cohort study. J Neurol. 2015;262(1):179–86. An interesting paper reporting no significant differences in hematological toxicity following valproate versus levetiracetam.

    Article  CAS  PubMed  Google Scholar 

  93. de Groot M, Douw L, Sizoo EM, Bosma I, Froklage FE, Heimans JJ, et al. Levetiracetam improves verbal memory in high-grade glioma patients. Neuro-Oncology. 2013;15(2):216–23.

    Article  PubMed Central  PubMed  Google Scholar 

  94. Saria MG, Corle C, Hu J, Rudnick JD, Phuphanich S, Mrugala MM, et al. Retrospective analysis of the tolerability and activity of lacosamide in patients with brain tumors: clinical article. J Neurosurg. 2013;118(6):1183–7. The first study reporting the efficacy of lacosamide in a cohort of patients with glioma and epilepsy.

    Article  CAS  PubMed  Google Scholar 

  95. Goonawardena J, Marshman LA, Drummond KJ. Brain tumour-associated status epilepticus. J Clin Neurosci. 2015;22(1):29–34.

    Article  PubMed  Google Scholar 

  96. Das RR, Artsy E, Hurwitz S, Wen PY, Black P, Golby A, et al. Outcomes after discontinuation of antiepileptic drugs after surgery in patients with low grade brain tumors and meningiomas. J Neuro-Oncol. 2012;107(3):565–70.

    Article  CAS  Google Scholar 

  97. Koekkoek JA, Kerkhof M, Dirven L, Heimans JJ, Postma TJ, Vos MJ, et al. Withdrawal of antiepileptic drugs in glioma patients after long-term seizure freedom: design of a prospective observational study. BMC Neurol. 2014;14:157.

    Article  PubMed Central  PubMed  Google Scholar 

  98. Weller M, Gorlia T, Cairncross JG, van den Bent MJ, Mason W, Belanger K, et al. Prolonged survival with valproic acid use in the EORTC/NCIC temozolomide trial for glioblastoma. Neurology. 2011;77(12):1156–64.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  99. Guthrie GD, Eljamel S. Impact of particular antiepileptic drugs on the survival of patients with glioblastoma multiforme. J Neurosurg. 2013;118(4):859–65.

    Article  CAS  PubMed  Google Scholar 

  100. Barker CA, Bishop AJ, Chang M, Beal K, Chan TA. Valproic acid use during radiation therapy for glioblastoma associated with improved survival. Int J Radiat Oncol Biol Phys. 2013;86(3):504–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Roberta Rudà and Riccardo Soffietti declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

Author information

Authors and Affiliations

  1. Department of Neuro-Oncology, University and City of Health and Science Hospital, Via Cherasco 15, 10126, Torino, Italy

    Roberta Rudà MD & Riccardo Soffietti MD

Authors
  1. Roberta Rudà MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Riccardo Soffietti MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roberta Rudà MD.

Additional information

This article is part of the Topical Collection on Neuro-oncology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rudà, R., Soffietti, R. What is New in the Management of Epilepsy in Gliomas?. Curr Treat Options Neurol 17, 24 (2015). https://doi.org/10.1007/s11940-015-0351-8

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11940-015-0351-8

Keywords

Search

Navigation