IDH1/2 mutation is associated with seizure as an initial symptom in low-grade glioma: A report of 311 Chinese adult glioma patients

Abstract

Seizure commonly presents as an initial symptom and plays an important role in the clinical presentation and quality of life of patients with low-grade glioma (LGG). To date, the mechanism and genetic alterations underlying tumor-related seizures in LGG remain to be fully elucidated. Both isocitrate dehydrogenase 1/2 (IDH1/2) mutation and seizure frequently occur in patients with LGG. We set out to investigate the potential relationship between IDH1/2 mutation and presentation of seizure preoperatively, and observe whether or not IDH1/2 mutation influences seizure control postoperatively. A total of 311 adult patients with LGG were enrolled in our study with both clinical data and IDH1/2 mutation data available. IDH1/2 mutation was detected directly by pyro-sequencing. The chi-squared test was performed to determine whether the IDH1/2 mutation has any relevance to seizure onset and to evaluate the potential impact that IDH1/2 mutation may exert on seizure control postoperatively. Seizure presented as an initial symptom in 71.4% (222/311) of patients with LGG, among which 189 patients were detected to bear IDH1/2 mutation in their tumors (P=0.035, chi-squared test). However, IDH1/2 mutation does not seem to contribute to the seizure control postoperatively (P=0.350 and 0.577 for the 6- and 12-month follow-up, respectively, chi-squared test). IDH1/2 mutation occurs more frequently in LGG patients with seizure as an initial symptom, suggesting a potential relationship between this genetic phenotype and clinical seizure presentation. IDH1/2 mutation shows no prognostic value for postoperative seizure control.