Clinical practice guidelines for the diagnosis and treatment of adult diffuse glioma‐related epilepsy

Abstract

Background Glioma‐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. Methods In 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. Results The manuscript presented the current standard recommendations for the diagnostic and therapeutic procedures of GRE. Conclusions The 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.

Radiomics Analysis of Postoperative Epilepsy Seizures in Low-Grade Gliomas Using Preoperative MR Images

“…Details concerning the administration of AEDs to glioma patients, including the drug dosage and duration of prescription, depended on clinical risk factors such as preoperative GRE and tumor resection, etc. ( 6 , 32 – 34 ). The standard of AEDs was still controversial and too broad for subjects, and lack of an accurate strategy for individuals now.…”

“…With a prolonged duration of epilepsy, the symptoms of LGG may spread to the neocortex and subcortical structures, gradually disrupting normal brain networks and causing dysfunction of both the peritumoral area and remote brain tissues ( 1 ). The reported recurrence of epilepsy in 20–40% of patients demonstrates that the current conventional treatment strategy used to address glioma-related epilepsy, including antiepileptic drugs (AEDs) and anti-tumor therapies, remain unsatisfactory ( 4 – 6 ). The application of AEDs has been a controversial issue for a long time, there still has no strategy for individualized prophylactic.…”

Epilepsy-Related Brain Network Alterations in Patients With Temporal Lobe Glioma in the Left Hemisphere

“…Seizures are a frequent symptom of brain tumors (1). Gliomas, particularly diffuse low-grade gliomas (DLGG, WHO grade 2), are highly epileptogenic (2).…”

Interleukin 4 Affects Epilepsy by Regulating Glial Cells: Potential and Possible Mechanism

“…Symptomatic seizure activity secondary to gliomas is referred to as glioma-associated epilepsy (GRE). The epileptogenesis of GRE involves multiple factors, including tumor location, degree of differentiation, tumor microenvironment, and specific genetic changes (Liang et al, 2019 ). In 65–90% of low-grade gliomas (LGG), epilepsy is the most common first symptom.…”