This research was developed to explore the clinical characteristics and related risk factors of postoperative recurrence and malignant transformation of low-grade glioma (LGG). The subjects were rolled into observation group (19 cases) and control group (51 cases) according to recurrence and malignant transformation during the follow-up period. The clinical data of the two groups were compared, and the risk factors of recurrence and malignant transformation were analyzed with the time of recurrence and malignant transformation as independent variables. The experimental results showed that the proportion of patients aged over 45 years in the observation group (63.16%) was higher than that in the control group (50.98%). The proportion of preoperative functional status score (KPS) ≥80 in the observation group (68.42%) was lower than that in the control group (78.43%). The proportion of patients with tumor over 5 cm in the control group (27.45%) was lower than that in the observation group (52.63%), and the proportion of total resection of tumor in the control group (47.06%) was higher than that in the observation group (21.05%). Furthermore, the multivariate analysis showed that preoperative KPS score, preoperative duration of disease, resection scope, postoperative treatment, oncotesticular antigen (OY-TES-1) mRNA, P53, mouse double microbody amplification gene (MDM2), vascular endothelial growth factor (VEGF), and epidermal growth factor receptor (EGFR) were independent risk factors (all P < 0.05 ). In summary, patients with postoperative recurrence and malignant transformation had poorer physical condition and higher degree of malignancy before surgery. Preoperative KPS score, duration of disease, surgical resection scope, postoperative treatment, OY-TES-1 mRNA, P53, MDM2, VEGF, and EGFR were the risk factors.

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Background Lennox-gastaut syndrome (LGS) is an epileptic encephalopathy often associated with behavioral and psychiatric disorders. Vagus nerve stimulation (VNS) has been approved effective for LGS treatment. Surgical resection is also an option for LGS patients with focal pathology, offering a high probability of seizure control. However, it is challenging to accurately localize the seizure focus. Case presentation The case presented here is a 19-year-old male with a 16-year history of epilepsy with comorbid severe cognitive and psychiatric disorders. He was diagnosed with LGS due to generalized slow spike-wave discharges and multiple seizure types. He was treated with VNS in 2017 at the age of 15. After that, the frequency of the short tonic seizures decreased from 4–5 times per day to 2–5 times per year, and the generalized tonic–clonic seizure pattern did not recur, which had a frequency of 2–4 times per month before the surgery. In 2019, the generalized abnormal interictal epileptiform discharges changed to be localized in the right frontal–temporal lobe at the age of 17 years (2019). Conclusions This case report suggested that the generalized epileptiform discharges evolve into localized discharges after VNS treatment, which may help reveal the primary seizure focus for resection surgery in patients with LGS.