Epilepsy associated with supratentorial brain tumors under 3 years of life

Roberto Gaggero, Alessandro Consales, Francesca Fazzini, Maria Margherita Mancardi, Maria Giuseppina Baglietto, Paolo Nozza, Andrea Rossi, Angela Pistorio, Miriam Tumolo, Armando Cama, Maria Luisa Garrè, Pasquale Striano

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To investigate the clinical features and outcome of epilepsy in children under 3 years of age with supratentorial brain tumors. Methods: Patients under 3 years with primary supratentorial hemispheric brain tumors were collected during a 10-year period through a database including demographic and clinical features, neuroimaging, tumor location, developmental outcome, pharmacological and surgical treatment, and tumor histology. Postoperative outcome was assessed according to Engel classification. Results: Among 28 children evaluated, twenty (71.4%) suffered from epilepsy. Mean age at seizure onset was 18.7 months (range: 1-60). In fifteen (75%) children, epilepsy was an early manifestation or the presenting symptom of the tumor; seizures were focal in 8 (53.3%) and generalized in 7 (46.7%) individuals. Three (15%) children presented with an epileptic encephalopathy and continuous spike-waves during sleep. Of the five children with epilepsy onset after surgery, four had focal seizures. Post-surgical follow-up ranged from 4 to 10 years (mean: 7.6 ± 3.74). The outcome of epilepsy was generally good, with most children (76.4%) being seizure free (Engel I) or showing >90% improvement in seizure frequency (Engel II) after surgery. However, in about 20% of the cases, epilepsy persisted despite surgery and different AEDs regimen. Best epilepsy outcome was observed in patients with low-grade tumors (p <0.01) and without neurological deficits after surgery (p <0.001). Conclusions: Epilepsy is a common and early symptom in infants with brain tumors. Its outcome is negatively influenced by high tumor malignancy and by the persistence of neurological deficits after surgery. Treatment of these patients needs a multidisciplinary approach.

Original languageEnglish
Pages (from-to)184-189
Number of pages6
JournalEpilepsy Research
Volume87
Issue number2-3
DOIs
Publication statusPublished - Dec 2009

Keywords

  • Long-lasting severe epilepsy
  • Neurosurgery
  • Pediatrics brain tumors

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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