Prevalence, Characteristics, and Long-Term Prognosis of Epilepsy Associated with Pediatric Brain Tumors

Hadar Weisman, Iris Fried, Tal Gilboa, Odeya Bennett-Back, Dana Ekstein, Moatasem Shweiki, Yigal Shoshan, Menachem Benifla

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective We investigated the prevalence, onset, characteristics, and long-term course of epilepsy disease in children who underwent surgical intervention for diagnosed brain tumors. Methods We reviewed the medical records of children with diagnosed brain tumors who underwent surgery during 2004–2014 at the Hadassah Medical Center. All patients with epilepsy were invited to a clinical visit that included a neurologic examination. The primary outcome measures were neurologic status according to the Glasgow outcome score (GOS) and postoperative seizure outcome according to the Engel system. We compared clinical characteristics according to the timing of epilepsy onset. Results The mean follow-up was 49 months. Of 128 patients included in the study, 44 (34%) had seizures; 23 (18%) developed epilepsy after surgery. Of the 30 patients with epilepsy who survived, 21 (70%) are in Engel class I and 13% Engel are in class II. Forty-five percent of the children are classified as GOS 5. Children who developed epilepsy after surgery were more likely to be in GOS 1–2 than were those who had seizures before surgery (P = 0.0173). Children with seizures were more likely to have cortical tumors and less likely to have tumors of the posterior fossa (P < 0.001). Children who underwent gross total resection were less likely to have epilepsy (P < 0.001). Conclusions We show a high incidence of epilepsy in the late course of pediatric brain tumor disease. In the long term, seizure outcome was excellent. However, postsurgical onset of epilepsy was associated with a less favorable neurologic outcome.

Original languageEnglish
Pages (from-to)e594-e600
JournalWorld Neurosurgery
Volume109
DOIs
StatePublished - 1 Jan 2018
Externally publishedYes

Keywords

  • Brain tumors
  • Epilepsy
  • Pediatric neurosurgery
  • Pediatric oncology
  • Postsurgical seizures

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