Intractable epilepsy associated with brain tumors in children: surgical modality and outcome

Abstract.

Objects: The aim of this study was to evaluate the role of surgical modality in children with brain tumors and intractable epilepsy. Methods: Twenty-three patients who were treated for brain tumors and intractable epilepsy between January 1985 and March 1998 were retrospectively reviewed. The most common tumors were dysembryoplastic neuroepithelial tumors (n=9), oligodendrogliomas (n=6), and gangliogliomas (n=5). Six patients exhibited cortical dysplasia. The mean duration of follow-up was 43.4 months (range 12 to 125 months). Seizure outcome was more favorable (Engel's classes I and II) in patients with a complete resection of tumor (14/14 vs 6/9 for incomplete resection; P<0.05). There was no significant difference in seizure outcome between lesionectomy (n=13) and epilepsy surgery (n=10). The likelihood of requiring postoperative antiepileptic drugs was not influenced by the extent of resection or type of surgery. Conclusions: On the basis of this study, we conclude that the complete resection of these tumors can be an appropriate initial treatment for children with brain tumors who experience intractable epilepsy.