Epilepsy and insular Grade II gliomas: an interdisciplinary point of view from a retrospective monocentric series of 46 cases

Abstract

OBJECTThere are few data in the literature concerning a multimodal approach to insular WHO Grade II gliomas (GIIGs) and the control of epilepsy after treatment. In this paper, the authors describe a monocentric series of 46 cases in which patients underwent various sequential treatments for insular GIIGs. On the basis of global results with regard to epilepsy, the respective interests in the various treatments are discussed.METHODSAvailable data on 46 patients harboring insular GIIGs were extracted from a local database of 288 GIIGs. The various therapeutic sequences were analyzed in parallel with the course of seizure frequency.RESULTSDespite the usual difficulties with seizure quantification in retrospective studies, the authors showed that 1) the negative course of seizure frequency was mostly connected to tumor progression, 2) surgery almost always had a favorable effect on epilepsy, and 3) chemotherapy had a mostly favorable effect with acceptable tolerance. The authors were unable to draw conclusions about the role of radiotherapy given the too few cases.CONCLUSIONSThis extensive experience with insular GIIGs tends to confirm interest in their surgical removal and supports interest in chemotherapy from an epileptological point of view.