[P1-82] Epilepsy in children with brain tumors: a retrospective clinical analysis
[Introduction] Brain tumors are found in 1-3 % of children with new-onset of seizures. Factors associated with seizure occurrence in pediatric brain tumors are tumor pathology, location, genetic change, chemotherapy, radiotherapy and metabolic abnormalities.
[Methods] Forty-five children aged from 21 days to 19 years of age with diagnosed brain tumors associated with seizures were enrolled. Clinical features of seizures, EEG findings, response of anti-epileptic drug and seizure control rate in relation to pathology of brain tumors were analyzed.
[Results] Grade 2 astrocytoma (28.9%) was found to be the most common CNS tumor with seizures in our series. Twenty-nine (64%) patients were benign and 16 (36%) were malignant tumors. Seizures with tumors were mostly in supratentorial region (96%) and most common located in temporal (33%), followed by parietal (24%) and frontal (24%). Seizures at presentation were more frequently in patients with benign tumors, whereas patients with malignant tumors tend to have delayed seizures (P < 0.001). EEGs were found to have focal epileptiform discharges in benign tumors, whereas focal and diffuse EEG slowing were found mostly in malignant tumors. Levetiracetam was found to be the most common antiepileptic drug in treatment of epilepsy with brain tumors (64.9%).
[Conclusions] Our results indicated that higher seizure frequency with normal neurologic examination may consider mostly benign tumors whereas seizures with focal weakness and IICP sign may have higher chance of malignancy. Delayed seizures were more frequently seen in malignant brain tumor group. Different tumor type and location may play an important part in epileptogenesis.
[Methods] Forty-five children aged from 21 days to 19 years of age with diagnosed brain tumors associated with seizures were enrolled. Clinical features of seizures, EEG findings, response of anti-epileptic drug and seizure control rate in relation to pathology of brain tumors were analyzed.
[Results] Grade 2 astrocytoma (28.9%) was found to be the most common CNS tumor with seizures in our series. Twenty-nine (64%) patients were benign and 16 (36%) were malignant tumors. Seizures with tumors were mostly in supratentorial region (96%) and most common located in temporal (33%), followed by parietal (24%) and frontal (24%). Seizures at presentation were more frequently in patients with benign tumors, whereas patients with malignant tumors tend to have delayed seizures (P < 0.001). EEGs were found to have focal epileptiform discharges in benign tumors, whereas focal and diffuse EEG slowing were found mostly in malignant tumors. Levetiracetam was found to be the most common antiepileptic drug in treatment of epilepsy with brain tumors (64.9%).
[Conclusions] Our results indicated that higher seizure frequency with normal neurologic examination may consider mostly benign tumors whereas seizures with focal weakness and IICP sign may have higher chance of malignancy. Delayed seizures were more frequently seen in malignant brain tumor group. Different tumor type and location may play an important part in epileptogenesis.