Awake Mapping for Grade 2 Glioma Reduces Intractable Epilepsy Burden

Managing tumor-related epilepsy remains a primary challenge in neuro-oncology, as seizures are frequently the presenting symptom and a major determinant of long-term quality of life [1]. While gross total resection is generally favored to improve both oncological and seizure outcomes, the proximity of many gliomas to eloquent cortex necessitates sophisticated surgical strategies [2, 3]. Awake craniotomy with intraoperative brain mapping has emerged as a standard approach to maximize the extent of resection while minimizing permanent neurological deficits [4, 5]. Despite these advancements, pharmacoresistant epilepsy persists in a significant subset of patients, often complicating their ability to return to work and maintain independence [6, 7]. A recent longitudinal study provides detailed evidence on how specific tumor characteristics and surgical metrics influence the trajectory of intractable epilepsy following functional mapping-based resection, offering clinicians clearer prognostic markers for counseling patients.