Résumé
Evaluation of: Khan T, Akhtar W, Wotton CJ, Hart Y, Turner M, Goldacre MJ. Epilepsy and the subsequent risk of cerebral tumour: record linkage retrospective cohort study. J. Neurol. Neurosurg. Psychiatry DOI: 10.11136/jnnp.2010.228130 (2011) (Epub ahead of print).Seizures are often the presenting symptoms of a cerebral tumor and may precede its diagnosis by many years. The article under evaluation searched two large English registries for patients admitted for new-onset epilepsy. The risk of subsequently being diagnosed with a malignant brain tumor was found to be 26-fold higher compared with controls, persisted over many years and was accentuated in young patients. Recently, surgical advances have led to a significant decrease in surgical morbidities, making surgery the first treatment option for gliomas, especially low-grade gliomas. This paradigm shift warrants a consequent diagnostic workup (MRI) in patients at risk for low-grade glioma - that is, patients with new-onset epilepsy. The study is discussed in the context of the ongoing debate on neuroimaging after new-onset epilepsy.