Published in:
01-09-2015 | Original Paper
Brain tumors in children with refractory seizures—a long-term follow-up study after epilepsy surgery
Published in: Child's Nervous System | Issue 9/2015
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Purpose
Epilepsy surgery is an established treatment option for medically refractory epilepsy. Brain tumors, besides dysplasias, vascular malformations, and other lesions, can cause refractory epilepsy. Long-term epilepsy-associated brain tumors, even though mostly benign, are neoplastic lesions and thus have to be considered as both epileptic and oncological lesions.
Methods
We retrospectively analyzed epileptological and oncological long-term follow-up (FU) in pediatric patients who underwent brain surgery for refractory epilepsy and whose histology showed a tumor as underlying cause (n = 107, mean FU 119 months).
Results
At last available outcome, 82.2 % of patients were seizure free (International League Against Epilepsy (ILAE) class 1) and seizure outcome was stable over more than 14 years. Fifty-four percent of the patients were without anti-epileptic drugs (AEDs) at last available outcome; 96.2 % of the tumors were classified WHO grade I and II and 3.7 % were malignant (WHO grade III). Adjuvant treatment was administered in 5.7 %; 2.9 % had relapse and one patient died (tumor-related mortality = 1.4 %). After surgery, 91 % of the patients attended regular school/university and/or professional training.
Conclusions
This study shows that epileptological outcome within this group is promising and stable and oncological outcome has a very good prognosis. However, oncological FU must not be dismissed as a small percentage of patients who suffer from malignant tumors and adjuvant treatment, relapse, and mortality have to be considered.