ObjectiveTo explore the clinical characteristics and surgical effect of low-grade glioma (LGG) secondary epilepsy.Methods45 cases of low-grade glioma secondary epilepsy were retrospectively studied during December 2010 and December 2020.There were 27 males and 18 females in this group. Their ages ranged from 10 to 69 years [mean (42.8±15.61) years]. And the illness duration ranged from 3 months to 5 years [mean (12.5±4.12) months]. The initial manifestation of all LGG was seizure attack.All the patients underwent CT and MRI examination before the operation. The LGG was located in the frontal lobe in 17 cases, temporal lobe in 8 cases, parietal lobe in 4 cases, frontal-temporal lobe in 7 cases, frontal-parietal lobe in 5 cases. Meanwhile the LGG was located in the left side in 31 cases, right side in 14 cases. The long-term video-EEG monitoring showed the epileptogenic lesion was located in the ispilateral frontal lobe in 20 cases, temporal lobe in 8 cases, frontal-temporal lobe in 12 cases, frontal-parietal lobe in 5 cases.All the patients were performed operation under the intra-operative electrocorticography (ECoG) monitoring.If necessary, enlarged epileptogenic cortical resection, cortical coagulation or MST was added.After the operation, all the patients were followed-up for half a year to 10 years [mean (4.7±1.83) years] to observe the surgical effect.Results42 cases of LGG underwent gross total resection and 3 subtotal resection intra-operatively. Anterial temporal lobectomy (ALT) was added in 19 cases whose LGG were invovled with temporal lobe.13 cases were added cortical cogulation and 5 cases MST.The post-operative pathology showed astrocytoma grade Ⅰin 20 cases, astrocytoma grade Ⅱ in 12 cases, oligodendroglioma in 11 cases and dysembryoplastic neuroepithelial tumor (DNET) in 2 cases. The post-operative follow-up showed that 30 cases lived well, 12 cases recurred and received re-operation, 3 cases died. Meanwhile, 42 cases were seizure free and 3 cases had occasional seizure attack during the follow-up.ConclusionsTo the patients with LGG secondary epilepsy, if pre-operative long-term EEG monitoring is in accordance with imaging examination, early LGG resection combined with epileptogenic lesion resection should be performed under the guidance of ECoG monitoring.And the post-operative effect is satisfactory.