Short-term and long-term changes in seizure frequency and neurocognitive status in pediatric patients after surgery for mixed neuronal-glial brain tumors

Abstract

Background. Neuronal and mixed neuronal-glial tumors are rare brain tumors that are most commonly observed in pediatric patients. The main clinical manifestations are presented by epilepsy substantially affecting child’s physical and neurocognitive development.Objective: to assess short-term and long-term changes in seizure frequency and neurocognitive status in pediatric patients who underwent surgery for mixed neuronal-glial tumors.Material and methods. Thirty-eight pediatric patients underwent surgery for mixed neuronal-glial tumors at the Almazov Research Medical Centre within the period from 2008 to 2018. All patients had comprehensive diagnostic examination including clinical neurological examination, neuroimaging tests, electroencephalography and electrocorticography before and after surgery. The postoperative changes in the seizures rate were assessed by using the 1993, 1996 Engel classification. Neurocognitive status was evaluated using The Child Behavior Checklist (a component of the Achenbach System of Empirically Based Assessment).Results. During the postoperative period, 84% of patients were found to be seizure-free; 42.6% demonstrated no clinically relevant behavioral disturbances or social adaption issues after the surgery. However, 76% of children experienced poor concentration. In a long-term perspective, seizures reoccured in 25% of patients and were not associated with any magnetic resonance signs of tumor progression.Conclusion. A gross total resection of the brain tumor was the main factor that affected changes over time in seizure rate. Assessment of long-term changes over time has shown that the patients tended to retain concentration difficulties, which should be taken into account while planning school education programs.