Gliomas are commonly associated with the development of seizures, and in some cases the two conditions share common pathogenic mechanisms.

A prospective-cohort study of patients with glioma evaluated at the Mayo Clinic, Florida between 2016 to 2018. Clinical data including presence of GPS, EEG, characteristics of glioma, and PSF were assessed.

68 patients (mean age= 51-years, 45-males) were enrolled. 46 patients had GPS: 52% with only focal seizures while 48% also had focal to bilateral tonic-clonic seizures. Gliomas were located in the frontal (n=29), temporal (n=19), parietal (n=14), occipital lobe (n=3), and insula (n=3). 32 patients had pre-operative scalp EEGs: epileptiform activity (EA) in only two. 57 patients underwent intra-operative electrocorticography during awake craniotomy-assisted glioma resection: EA in 36, with intraoperative seizures seen in 7. 53 underwent gross-total resection: pilocytic astrocytoma (n=2), diffuse astrocytoma (n=4), oligodendroglioma (n=15), anaplastic astrocytoma (n=16), and glioblastoma (n=31). IDH1 mutations were seen in 32/68, MGMT methylation in 15/36, 1p/19q co-deletion in 15/21, over, and expression of p53 in 19/57. IDH2 mutation status was unknown for the majority. 31(67%) patients had PSF (mean follow-up=9 months). Patients with IDH1 mutation were likely to have GPS (p=0.037) and PSF (p=0.038). Patient without MGMT methylation (p=0.031) were also likely to have PSF. For the glioblastoma subtype, those without MGMT methylation were likely to have GPS (p=0.032). PSF or GPS did not differ by age, sex, glioma location/grade/histopathological subtype, or other tumor molecular markers (TMMs).