Clinical and electroencephalographic data indicative of brain tumours in a seizure population

Brain tumors are a common cause of seizures in children. Early surgical treatment can improve seizure outcome, but controversy exists regarding the most appropriate type of surgical intervention. Some studies suggest tumor resection alone is sufficient, while others recommend mapping and resection of the surrounding epileptogenic foci to optimize seizure outcome. To address this issue, we reviewed the charts of 34 pediatric patients aged 18 months to 20 years with medically intractable epilepsy and primary brain tumors. The average age at operation was 12.6 years, and patients had seizures for an average of 6.4 years. The majority of tumors were located in the temporal lobe. Seventeen patients, because of tumor location near an eloquent area, underwent extraoperative mapping using subdural electrode grids prior to definitive tumor resection. Fourteen of these patients had a gross total tumor resection, yet only two had a distinct zone of ictal onset identified and resected. The remaining 17 patients had tumors either in the nondominant hemisphere or far removed from speech-sensitive areas, and therefore did not undergo extraoperative subdural electroencephalograph mapping. Fourteen of these patients also had a gross total tumor resection, while none had intraoperative electrocorticography to guide the resection of additional nontumoral tissue. Overall, of the 28 patients treated with a gross total tumor resection, 24 (86%) are seizure free, while the other four are significantly improved. Of the six patients who had a subtotal tumor removal, five have persistent seizures. The mean follow-up was 3.6 years. We conclude that in children and adolescents, completeness of tumor resection is the most important factor in determining seizure outcome. The routine mapping and resection of epileptogenic foci might not be necessary in the majority of patients. As a corollary, the use of subdural electrode grids in pediatric patients with tumor-associated epilepsy should be limited to cases requiring extraoperative cortical stimulation for localization of nearby eloquent cortex.

show abstract

“…The postoperative MRI revealed no residual tumor (Figure 6). 8 (80%) had good outcomes (7 seizure free, 1 reduced seizures). Four of 11 Figure 3.…”

Section: Tumor Type and Locationmentioning

confidence: 99%

Surgical Management of Pediatric Tumor-Associated Epilepsy

et al. 1999

View full text Add to dashboard Cite

show abstract

“…40% of patients with Intracranial tumours (gliomas, meningiomas, metastases etc.,) had seizures is the presenting complaint 7 In adults tumours are found in 6-20% of the seizures population. 8 Sheehan 1958, Rasmussen 1968, Carney et al 1969, Currie et al 1971, Vigaendra et al 1978.…”

Section: Intracranial Tumours and Epilepsymentioning

confidence: 99%

A Study of Aetiology of First Episode of Seizures in Adults

Shafee¹,

Rahim²

2018

jebmh

View full text Add to dashboard Cite

BACKGROUND Epilepsy is probably as old as man himself. Jackson (1931) described epilepsy "as a sudden excessive rapid discharge of grey matter of some part of the brain". Seizures are common disorders, the average incidence rate in most studies is 20-70/1,00,000 per year (range 11 "134/1,00 000 per year). Incidence varies considerably with age, rates are greatest in early childhood, reach a nadir in early adult life, and rise again in elderly person. The aims and objective of the study are: 1) To investigate for the aetiology of First episode of seizures in adults. 2) To study the clinical course of admitted cases with First time seizures. MATERIALS AND METHODS Inclusion Criteria-Patients in the medical wards with history and clinical features suggestive of seizures for the first time are included in the study. A provisional diagnosis made on clinical grounds and substantiated by carrying out appropriate Biochemical, Pathological, and Radiological investigation. A detailed analysis for aetiology and the clinical presentation will be studied. Exclusion Criteria-Patients with past history of seizures, head injury on anti-epileptic drug treatment were excluded. RESULTS This study included 45 patients examined and treated in the Dept. of Medicine. Their ages ranged from 15 to 75 years. The 45 patients studied were divided into 6 age groups. CONCLUSION This study included 45 patients (more than 15 years of age) presenting with seizures. Patients with past history of seizures, head injury on anti-epileptic drug treatment were excluded. There were 33 males 12 females and ages ranged from 15 to 75 years. Detailed history was obtained and physical examination was done in each patient.

show abstract