INTRODUCTION:

Seizures are frequent as initial symptom in low grade gliomas and it occurs commonly in follow-up in high grade glioma. Antiepileptic drugs achieve seizure control in most of cases. However, in aproximately 1/3 of cases multiple antiepileptic drugs are needed which could increase neurocognitive side effects and impair quality of life.

Objectives: To establish frequency of seizures and antiepileptic drugs use in a group of patients with diffuse brain gliomas at the outpatient neurology department.

PATIENTS AND METHODS:

Retrospective, descriptive case series of adult patients with brain diffuse glioma confirmed by histological criteria. Clinical data was analised by descriptive statistics and Fisher's test was used to compare variables.

RESULTS:

We included 42 patients (age average 41 years, range 15-71) 15 grade II gliomas (7 astrocitoma, 4 oligodendroglioma, 2 mixed gliomas, 2 gliomas not specified) and 27 high-grade gliomas (14 glioblastoma, 8 astrocitoma III, 3 oligodendroglioma, 2 mixed gliomas). During follow-up 36 (85%) of patients had seizures and it was the initial symptom in 28 (66%) of cases significantly more frequent in low-grade gliomas (93% low grade vs 51 high grade, p=0.07). Overall, monotherapy with antiepileptic drugs were possible in 23 cases (63%). For low-grade glioma only 40% of patients responded to monotherapy whereas it was successful in 80% of high-grade gliomas (p=0.01).

CONCLUSION:

Seizures were more frequent in low-grade gliomas and often it required a combined antiepileptic drugs regimen to achieve epilepsy control compared to high-grade gliomas.

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