Child's Nervous System

, Volume 31, Issue 9, pp 1471–1477 | Cite as

Brain tumors in children with refractory seizures—a long-term follow-up study after epilepsy surgery

  • Caroline Wessling
  • Susanne Bartels
  • Robert Sassen
  • Jan-Christoph Schoene-Bake
  • Marec von Lehe
Original Paper
First Online:
Received:
Accepted:

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.

Keywords

Epilepsy surgery Brain tumor Pediatrics Follow-up studies 
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Notes

Compliance with ethical standards

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

For this type of study formal consent is not required.

This article does not contain any studies with animals performed by any of the authors.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity Hospital BonnBonnGermany
  2. 2.Department of EpileptologyUniversity Hospital BonnBonnGermany
  3. 3.Department of PediatricsBraunschweig General HospitalBraunschweigGermany
  4. 4.Department of NeurosurgeryUniversity Hospital BochumBochumGermany
  5. 5.Department of NeurosurgeryClemens HospitalMuensterGermany

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