You Gan, Sha Zhiyi, Jiang Tao
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Medical School, University of Minnesota, Minneapolis, MN, United States.
Front Oncol. 2021 Jan 14;10:550353. doi: 10.3389/fonc.2020.550353. eCollection 2020.
Gliomas account for more than half of all adult primary brain tumors. Epilepsy is the most common initial clinical presentation in gliomas. Glioma related epilepsy (GRE) is defined as symptomatic epileptic seizures secondary to gliomas, occurring in nearly 50% in high-grade glioma (HGG) patients and up to 90% in patients with low-grade glioma (LGG). Uncontrolled seizures, which have major impact on patients' quality of life, are caused by multiple factors. Although the anti-seizure medications (ASMs), chemotherapy and radiation therapy are also beneficial for seizure treatment, the overall seizure control for GRE continue to be unsatisfactory. Due to the close relationship between GRE and glioma, surgical resection is often the treatment of choice not only for the tumor treatment, but also for the seizure control. Despite aggressive surgical treatment, there are about 30% of patients continue to have poor seizure control postoperatively. Furthermore, the diagnostic criteria for GRE is not well established. In this review, we propose an algorithm for the diagnosis and perioperative management for GRE.
胶质瘤占所有成人原发性脑肿瘤的一半以上。癫痫是胶质瘤最常见的初始临床表现。胶质瘤相关性癫痫（GRE）被定义为继发于胶质瘤的症状性癫痫发作，在高级别胶质瘤（HGG）患者中发生率近50%，在低级别胶质瘤（LGG）患者中高达90%。不受控制的癫痫发作对患者的生活质量有重大影响，其由多种因素引起。尽管抗癫痫药物（ASMs）、化疗和放射治疗对癫痫治疗也有益，但GRE的总体癫痫控制仍然不尽人意。由于GRE与胶质瘤关系密切，手术切除通常不仅是肿瘤治疗的首选，也是癫痫控制的首选。尽管进行了积极的手术治疗，但仍有大约30%的患者术后癫痫控制不佳。此外，GRE的诊断标准尚未明确确立。在本综述中，我们提出了一种GRE的诊断及围手术期管理算法。
