Management of glioma-associated epilepsy in the molecular era: a review of the literature and an institutional experience.

Abstract

Seizures following resection for glioma can significantly impact patient quality of life. Resection and antiseizure medications have been first-line treatments for glioma-associated epilepsy since the survival benefit of maximizing the extent of resection was established. Given recent advances in tumor molecular profiling and neuron-glioma circuit interactions, should the management of tumor-associated epilepsy change? Here the authors present a literature review of the current state of the surgical and medical management of postoperative seizures in patients with glioma, summarize key findings from investigations of the molecular processes governing tumor-associated seizures, and provide a retrospective review correlating tumor mutational profiles obtained from next generation sequencing with seizure history in patients from a single institution. This paradigm of comparing clinical seizure outcomes and tumor genetics may broaden the understanding of glioma-associated epilepsy and prognostic factors, potentially leading to new therapeutic strategies.