Skip to main content

Advertisement

SpringerLink
Log in

Signs and symptoms of pediatric brain tumors and diagnostic value of preoperative EEG

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

In pediatric patients, brain tumors have been estimated to be the cause for seizures in only 0.2–0.3 % of cases, whereas seizures occurred in about 13 % of pediatric brain tumor patients at presentation. This survey was conducted to analyze EEG findings in pediatric tumor patients over the past 14 years to evaluate the diagnostic value of preoperative EEG for diagnosis of brain tumors. Surface EEG was obtained in awake patients using the international 10- to 20-electrode placement in all pediatric patients with intracranial neoplasms between 2000 and 2013 at the University Hospital of Leipzig except for those who needed emergency operative treatment. One hundred forty-two pediatric patients with 80 infratentorial and 62 supratentorial tumors (WHO grades I–II: 91 patients; WHO grades III–IV: 46 patients). Symptomatic hydrocephalus was found in 37. Sensitivity and specificity of ophthalmologic examination for predicting hydrocephalus was 0.39 and 0.72. Preoperative EEG has been conducted in 116 patients, showing normal activity in 54 patients (47 %). Out of 62 pathologic EEGs, 40 indicated correctly to the site of the lesion, 15 were pathologic despite of infratentorial location of the tumor. Nineteen patients had a history of seizures of which six had normal EEGs. Sensitivity for and specificity of EEG examination for symptomatic epilepsy was 0.68 and 0.7.

Conclusion Preoperative routine EEG provides no additional value in the diagnostic algorithm of pediatric train tumors. The low specificity and sensitivity of EEG (even in patients with clinical seizures as primary symptom of a brain tumor) underline that EEG does not contribute to diagnosis and a normal EEG might even delay correct diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

AT/T:

Atypical teratoid/rhabdoid tumor

CSF:

Cerebral spinal fluid

DNET:

Dysembryoplastic neuroepithelial tumor

DOGLT:

Disseminated oligodendroglial-like leptomeningeal tumor

EEG:

Electroencephalogram

GBM:

Glioblastoma

PA:

Pilocytic astrocytoma

PNET:

Primitive neuroectodermal tumor

References

  1. Cascino GD (1990) Epilepsy and brain tumours. Epilepsia 37:S37–S44

    Article  Google Scholar 

  2. Duffner PK (2010) Risk factors for cognitive decline in children treated for brain tumors. Eur J Pediatr Neurol 14:106–115

    Article  Google Scholar 

  3. Edgeworth J, Bullock P, Bailey A, Gallagher A, Crouchmann M (1996) Why are brain tumours still being missed? Arch Dis Child 74:148–151

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Fattal-Valevski A, Nissan N, Kramer U, Constantini S (2012) Seizures as the clinical presenting symptom in children with brain tumours. J Child Neurol 28:292–296

    Article  PubMed  Google Scholar 

  5. Flores LE, Williams DL, Bell BA et al (1986) Delay in the diagnosis of pediatric brain tumors. Am J Dis Child 140:684–686

    CAS  PubMed  Google Scholar 

  6. Gilles FH, Sobel E, Leviton A et al (1992) Epidemiology of seizures in children with brain tumors. The Childhood Brain Tumor Consortium. J Neurooncol 12:53–68

    Article  CAS  PubMed  Google Scholar 

  7. Hayashi N, Kidokoro H, Miyajima Y, Fukazawa T, Natsume J, Kubota T, Kojima K (2010) How do the clinical features of brain tumours in childhood progress before diagnosis? Brain Dev 32:636–641

    Article  PubMed  Google Scholar 

  8. Hirtz D, Ashwal S, Berg A, Bittis D, Camfield C, Camfield P, Crumrine P, Elterman R, Schneider S, Shinnar S (2000) Practice parameter: evaluating a first nonfebrile seizure in children. Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society. Neurology 55:616–623

    Article  CAS  PubMed  Google Scholar 

  9. Ibrahim K, Appleton R (2004) Seizures as the presenting symptom of brain tumours in children. Seizure 13:108–112

    Article  PubMed  Google Scholar 

  10. Klitbo DM, Nielsen R, Illum NO, Wehner PS, Carlsen N (2011) Symptoms and time to diagnosis in children with brain tumours. Dan Med Bul 58:A4285

    Google Scholar 

  11. Kukal K, Dobrovoljac M, Boltshauer E, Ammann RA, Grotzer MA (2009) Does diagnostic delay result in decreased survival in paediatric brain tumours? Eur J Pediatr 168:303–310

    Article  PubMed  Google Scholar 

  12. Martens D, Oster I, Gottschling S, Papanagiotou P, Ziegler K, Eymann R, Ong MF, Gortner L, Meyer S (2012) Cerebral MRI and EEG studies in the initial management of pediatric headaches. Swiss Med Wkly 142:w13625

    PubMed  Google Scholar 

  13. Metha V, Chapman A, McNeely PD, Walling S, Hower WJ (2002) Latency between symptom onset and diagnosis of pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery 51(2):365–372, discussion 372–3

    Google Scholar 

  14. Patel H, Garg BP, Salanova V, Boaz JC, Luerson TG, Karlsbeck JE (2001) Tumor-related epilepsy in children. J Child Neurol 16(2):141–145

    Article  CAS  PubMed  Google Scholar 

  15. Pavone P, Conti I, Le Pira A, Pavone L, Verrotti A, Ruggieri M (2011) Primary headache: role of investigations in a cohort of young children and adolescents. Pediatr Int 53:964–967

    Article  PubMed  Google Scholar 

  16. Reulecke BC, Erker CG, Fiedler BJ, Niederstadt TU, Kurlemann G (2008) Brain tumors in children: initial symptoms and their influence on the time span between symptom onset and diagnosis. J Child Neurol 23:178–183

    Article  PubMed  Google Scholar 

  17. Sjors K, Blennow G, Lantz G (1993) Seizures as the presenting symptoms of brain tumors in children. Acta Paed 82:66–70

    Article  CAS  Google Scholar 

  18. Williams BA, Abbott KJ, Manson JI (1992) Cerebral tumors in children with epilepsy. J Child Neurol 7:291–294

    Article  CAS  PubMed  Google Scholar 

  19. Wilne SH, Ferris RC, Nathwani A, Kennedy CR (2006) The presenting features of brain tumours: a review of 200 cases. Arch Dis Child 91:502–506

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D (2007) Presentation of childhood CNS tumours: a systematic review and meta-analysis. Lancet Oncol 8:685–695

    Article  PubMed  Google Scholar 

  21. Wilne S, Koller K, Collier J, Kennedy C, Grundy R, Walker D (2010) The diagnosis of brain tumours in children: a guideline to assist healthcare professionals in the assessment of children who may have a brain tumour. Arch Dis Child 95:534–539

    Article  PubMed  Google Scholar 

  22. Wilne SH, Dineen RA, Dommett RM, Chu RPC, Walker DA (2013) Identifying brain tumours in children and young adults. BMJ 347:f5844

    Article  CAS  PubMed  Google Scholar 

Download references

Ethical standard statement

A local ethics committee approval had been granted for retrospective analysis of the data (Ethikkommission Universität Leipzig, Az 134-13-03062013).

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Pediatric Neurosurgery, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany

    Matthias Preuß & Ulf Nestler

  2. Division of Neuropediatrics, University Hospital Leipzig, Leipzig, Germany

    Sophia Preiss, Steffen Syrbe, Andreas Merkenschlager, Astrid Bertsche & Matthias K. Bernhard

  3. Department of Pediatric Oncology and Hematology, University Hospital Leipzig, Leipzig, Germany

    Lars Fischer & Holger Christiansen

Authors
  1. Matthias Preuß
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sophia Preiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steffen Syrbe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ulf Nestler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lars Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andreas Merkenschlager
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Astrid Bertsche
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Holger Christiansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Matthias K. Bernhard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthias Preuß.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Preuß, M., Preiss, S., Syrbe, S. et al. Signs and symptoms of pediatric brain tumors and diagnostic value of preoperative EEG. Childs Nerv Syst 31, 2051–2054 (2015). https://doi.org/10.1007/s00381-015-2842-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-015-2842-z

Keywords

Search

Navigation