Epileptic seizures in patients with glioma: A single centre-based study in China

Purpose: To elucidate the outcomes of treatment and epidemiology of epilepsy related to glioma in a single center in Chinese patients.
Methods: Prescription medicines usage and clinical data were collected from medical records of 119 patients with gliomas between August 2009 and September 2015. Fisher’s exact and Chi square tests were used for analysis of seizure incidence differences as per WHO Grades, histology, location as well as tumour number, age and sex.
Results: Preoperative seizures were noted in 33.8 % of glioma patients. After surgery, all the patients were given antiepileptic drugs (AEDs) prophylactically. Ten patients (8.4 %) developed seizures in the initial postoperative week, and 73 (61.3 %) patients at the last follow-up period. Overall, seizure incidence was 74.2 % in WHO Grade II, 68.4 % in Grade III, and 56.6 % in Grade IV glioma patients. Good seizure control and tolerance was demonstrated by levetiracetam. Phenytoin/carbamazepine were poorly tolerated due to adverse events. AED discontinuation was done in 54 patients and 14 patients developed seizures within 6 months and again needed AED.
Conclusion: Effective prophylaxis of seizure and acceptable adverse event profile are to be considered significantly in AEDs selection. Lower cognitive impairment risk and renal excretion associated with newer AEDs make them better than older therapeutic agents for epilepsy control in brain tumour patients.

Keywords
Brain tumour; Epilepsy; Glioma; Seizures; Levetiracetam; Phenytoin; Carbamazepine; Epidemiology