Di Bonaventura C, et al. – The relationship between seizures and high–grade gliomas (HGG) relapse (HGG–R) was investigated in this study. Before MRI detection of relapse, seizures could herald HGG–R, therefore implying that seizures ought to be considered as a red flag during follow–up.

• A total of 145 patients who were surgically treated for HGG-R were retrospectively assessed.
• The clinicians identified 37 patients with seizures during follow-up by analyzing clinical characteristics in these patients (all operated and treated by the same protocol).
• According to presence or absence of seizures at the time of diagnosis and temporal relationship between seizure occurrence and HGG-R during follow-up, they divided this cohort into 4 subgroups:
  • Subgroup A (25 pts) had seizures at follow-up but not at onset
  • Subgroup B (12 pts) had seizures both at follow-up and onset
  • Subgroup C (30 pts) had seizures before MRI-documented HGG-R
  • Subgroup D (7 pts) had seizures after MRI-documented HGG-R.

• During follow-up, survival was longer in patients with seizures than in those without seizures (59.3% vs 51.4% alive at 2 years) although the datum was not statistically significant.
• In 30 patients (subgroup C) seizures indicated HGG-R.
• The time interval between seizure and the HGG-R was significantly correlated with the number of chemotherapy cycles (r = 0.470; p = 0.009) and follow-up duration (r = 0.566; p = 0.001) in a correlation analysis for this last subgroup.
• A linear regression model showed a reciprocal relationship between the above factors and that it could be possible to estimate the timing of HGG-R by combining these data.