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- Title
Brain tumors in children with refractory seizures-a long-term follow-up study after epilepsy surgery.
- Authors
Wessling, Caroline; Bartels, Susanne; Sassen, Robert; Schoene-Bake, Jan-Christoph; Lehe, Marec
- Abstract
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.
- Subjects
EPILEPSY surgery; BRAIN tumors; PYRAMIDAL neurons; HEALTH outcome assessment; SPASMS
- Publication
Child's Nervous System, 2015, Vol 31, Issue 9, p1471
- ISSN
0256-7040
- Publication type
Article
- DOI
10.1007/s00381-015-2825-0