Abstracts

Seizures are reported in 20-45% of brain tumor patients, most frequently in patients with supratentorial tumors. Studies suggested that seizures related to brain tumors are more refractory to antiepileptic drugs (Schaller B, Epilepsia 2003). The goal of this study is to identify the incidence of seizures in children with brain tumors, and specifically the incidence of intractable seizures. Retrospective record review of 199 hospitalized pediatric patients with brain tumors treated at Schneider Children[rsquo]s Hospital between 1998 and 2003. Out of 199 patients, sufficient information was obtained from the records of 164 patients. Thirteen patients with optic gliomas, cavernous angiomas and metastatic tumor were excluded. The remaining 151 patients constituted the study population. Eighty-nine had infratentorial tumors, 62 had supratentorial tumors. Eleven percent (10/89) of patients with infratentorial tumors had seizures, mostly related to acute hydrocephalus and to surgical or non-surgical treatment complications. Forty eight percent (30/62) of the patients with supratentorial tumor had seizures, mostly (20/30, 67%) as part of the initial presentation. Thirty percent (12/40) of all seizure patients had used 3 or more antiepileptic drugs and 12.5% (5/40) patients met the criteria for intractable seizures defined as failing 2 antiepileptic drugs and more than 1 seizure per month for 18 months. All 5 patients with intractable seizures had either residual tumors or tumor recurrence requiring 2 or more surgical intervention ( Table1).[table1] The intractable epilepsy rate of 12.5 % in this population is similar to the rate reported in non-tumor epilepsy children (Berg AT, neurology 2001). Our data did not support the hypothesis that brain tumor patients have higher risk for medically refractory seizures (95% confident interval 2.3%-23%). Seizures in infratentorial tumors are mostly related to hydrocephalus or treatment. Significant proportion of the patients with supratentorial tumor had seizures as their initial presentation.