Abstract
BackgroundGlioma‐related epilepsy (GRE) is defined as symptomatic epileptic seizures secondary to gliomas, it brings both heavy financial and psychosocial burdens to patients with diffuse glioma and significantly decreases their quality of life. To date, there have been no clinical guidelines that provide recommendations for the optimal diagnostic and therapeutic procedures for GRE patients.MethodsIn March 2017, the Joint Task Force for GRE of China Association Against Epilepsy and Society for Neuro‐Oncology of China launched the guideline committee for the diagnosis and treatment of GRE. The guideline committee conducted a comprehensive review of relevant domestic and international literatures that were evaluated and graded based on the Oxford Centre for Evidence‐Based Medicine Levels of Evidence, and then held three consensus meetings to discuss relevant recommendations. The recommendations were eventually given according to those relevant literatures, together with the experiences in the diagnosis and treatment of over 3000 GRE cases from 24 tertiary level hospitals that specialize in clinical research of epilepsy, glioma, and GRE in China.ResultsThe manuscript presented the current standard recommendations for the diagnostic and therapeutic procedures of GRE.ConclusionsThe current work will provide a framework and assurance for the diagnosis and treatment strategy of GRE to reduce complications and costs caused by unnecessary treatment. Additionally, it can serve as a reference for all professionals involved in the management of patients with GRE.
Highlights
Glioma‐related epilepsy (GRE) is defined as symptomatic epileptic seizures secondary to gliomas
The effect of current conventional treatment strategy for GRE, which consists of antiepileptic drugs (AEDs) and anti‐tumor therapies, is unsatisfactory, despite the above treatments, seizures cannot be effectively controlled in 20%‐40% of patients.[1,8]
Isocitrate dehydrogenase 1 (IDH1) mutation, younger age (
Summary
Glioma‐related epilepsy (GRE) is defined as symptomatic epileptic seizures secondary to gliomas. In terms of seizure control, gross‐total resection is better than sub‐total resection.[9,13,15,47] A recent study showed that for LGG patients with preoperative epilepsy, the postoperative seizure control was more likely when the extent of resection was over 91%.48 “supratotal” resection can achieve better seizure control than even gross‐total resection.[49] for patients with GRE, the maximal safe resection is helpful to improve local tumor control and survival and postoperative seizure control.
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