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Low-grade gliomas (LGGs) account for about a third of gliomas overall and 15% of all primary brain tumours. In adults, the majority of LGGs are WHO Grade II astrocytomas and oligodendrogliomas, which differ in molecular fingerprints and median survival, but share a propensity to malignant transformation after a number of years. Up to 90% of LGGs present with seizures and epilepsy may be the only symptom for many years, significantly impairing quality of life and impacting on social and professional functioning.1 In about 50% of cases, the epilepsy is refractory to antiepileptic drugs (AEDs) with a quarter of patients requiring 3 or more AEDs.2 Koekkoek et al3 report on the effect of temozolomide (TMZ), an oral alkylating chemotherapy agent, on seizures in LGG, and surprisingly find a positive impact on prognosis in those patients deriving significant seizure reduction.
Owing to the large variability in prognosis and the …