Low-Grade Glioma: Managing Side Effects

Pictured: Antonio Omuro Neuro-oncologist Antonio Omuro checks for side effects in a patient following treatment for low-grade glioma. Side effects can occur during or shortly after treatment, or may appear months or years later.

Treatment for low-grade glioma can result in side effects, including changes in cognitive function and seizures. Memorial Sloan Kettering offers a range of therapies for dealing with these side effects.

Treatment for Cognitive Side Effects

Brain tumors and their treatment can affect cognitive functions such as thinking and memory. In some cases, the tumor itself causes cognitive problems. In others, chemotherapy, radiation therapy, or surgery can affect brain function. These side effects develop for some patients during or shortly after their treatment; for others, side effects may appear months or years later.

Cognitive changes can be obvious to others, or can be so subtle that your friends and family fail to notice. They commonly include:

  • Trouble remembering details, such as names and dates
  • Short attention span or difficulty concentrating
  • Difficulty with short-term memory and learning new information
  • Problems multitasking, such as cleaning and talking on the phone at the same time

At the Brain Tumor Center, therapy for these and other cognitive side effects is integrated into your treatment and follow-up care. Memorial Sloan Kettering neuropsychologists and psychiatrists work closely with neurologists on your disease management team to assess and develop a strategy to manage any treatment-related impairment.

Treatment for cognitive side effects can include medications and/or cognitive rehabilitation. We can prescribe medications that activate your brain and reduce fatigue. We can also teach you rehabilitation techniques to compensate for thinking and memory problems.

Unfortunately, there is no definitive treatment for cognitive changes associated with cancer treatment. However, we are researching various approaches, and trying to better understand how treatment affects brain structure and function.

Treatment for Seizures

A common symptom of low-grade glioma and other brain tumors is seizures, which occur when an abnormality in the brain causes unusual surges in the electrical activity through which nerve cells communicate with each other. Depending on the part of the brain in which the tumor is located, seizures can lead to temporary problems in consciousness, movement, or speech.

Fortunately, there are medicines that can help to control seizures. Because many people undergoing treatment for brain tumors are also receiving chemotherapy or other drugs, however, it is important to coordinate antiseizure medications with other medications you are taking.

At Memorial Sloan Kettering, your neurologist will work closely with your neuro-oncologist and other doctors to prescribe appropriate antiseizure medications that minimize your risk of dangerous drug interactions. Your team will also work together to monitor for side effects and to ensure that the tumor and any seizures you might be experiencing are managed in ways that best preserve your quality of life.

In rare cases, patients can have ongoing problems with seizures, despite being on several antiseizure medications. Our brain tumor team includes neurologists who specialize in managing seizures. We are able to monitor the electrical activity of the brain waves through a test called an electroencephalogram, or an EEG, which can often be performed during a routine visit to a neurologist.

Patients who have ongoing problems with seizures may need continuous monitoring of their brain waves. This can sometimes be done with an ambulatory EEG, where you wear a special brain wave monitor for up to 72 hours as you go about your usual activities. Other patients may require EEG monitoring in the hospital in our specially equipped room that allows us to monitor your brain continuously. Our experts are able to visualize your movements during seizures and you have round-the-clock access to our seizure experts. 

Information obtained from these EEGs can guide our neurologists in improving your seizure control and may help our surgeons in performing a procedure to remove specific parts of the brain or brain tumor that are responsible for the seizure activity.

Having a seizure specialist as a part of your team ensures that any recurrence or persistence of seizures can be managed continually as a part of your overall care.