Epidemiology of seizures in children with brain tumors

Abstract

We examined potential clinical and pathologic correlates of seizures among the 3,291 children in the Childhood Brain Tumor Consortium database. Fourteen percent had seizures prior to their hospitalization for a brain tumor. Among children who had a supratentorial tumor, seizures occurred in 22% of those less than 14 years of age. The prevalence of seizures increased to 68% of older teenagers. Among children with an infratentorial tumor, the prevalence of seizures was relatively constant at 6% over all age groups. The onset of seizures began more than one year prior to surgical tumor removal in over half of the children aged five or more with supratentorial tumors, significantly longer than for those of the same age with infratentorial tumors. Almost all children (98.9%) with an infratentorial tumor and seizures had at least one other symptom and more than three-fourths of them had at least three. Eighty-nine percent of children with a supratentorial tumor and seizures had at least one other symptom and more than one-half had at least three symptoms. Regardless of whether the tumor was above or below the tentorium, confusion or stupor and coma were more common in children with seizures than in children without seizures. Among children with supratentorial tumors, symptoms of a declining academic performance or an abnormality of personality, speech, walking, or sensation were significantly more frequent in children with seizures, while visual symptoms (other than visual loss or diplopia) and nausea or vomiting were less frequent. Among children with supratentorial tumors, those who had seizures were more likely to have paralysis of an arm, hand, or face, confusion or stupor, or coma and less likely to exhibit irritability, papilledema, optic atrophy, decreased visual acuity, pupillary abnormalities, or abducens paresis. Among children with infratentorial tumors, those with seizures were significantly less likely to have truncal ataxia, but more likely to experience confusion, stupor, or coma. In the supratentorial compartment, astrocytoma (nos), protoplasmic astrocytoma, anaplastic astrocytoma, and ependymoma were more frequently associated with seizures than was craniopharyngioma. No infratentorial tumor type was more or less likely to be associated with seizures. All common tumor types that were represented in both the supratentorial and the infratentorial compartment except astrocytoma (nos) were associated with significantly greater rates of seizures when located in the supratentorial compartment. The tumor location with the highest incidence of seizures was, as expected, the superficial cerebrum. More than 40% of the children with such tumors had seizures.(ABSTRACT TRUNCATED AT 400 WORDS)

Seizure Disorders in Patients with Brain Tumors

“…Shady et al [8]found the 50% seizure incidence with no association between age at diagnosis and seizure activity in children with supratentorial astroglial neoplasms. In their study of 3,291 children with brain tumors, Gilles et al [18]reported that 14% of them experienced seizures, while the incidence increased monotonically throughout childhood. In adults with malignant gliomas, seizures at presentation were found more commonly in patients younger than 50 years [9].…”

“…Superficial tumors involving the isocortex without known deep extension were associated with the highest rate of seizures significantly more often than if the tumor had a deep extension [18]. Seizure rates associated with frontal or temporal tumors were also significantly reduced in the presence of deep extensions of the tumor.…”

“…With regard to tumor location, seizures have been reported to occur in 22–68% of patients with supratentorial tumors involving most commonly the temporal and frontal lobes [1, 9, 10]and in only 1–6% of patients with infratentorial lesions [8, 18]. Superficial tumors involving the isocortex without known deep extension were associated with the highest rate of seizures significantly more often than if the tumor had a deep extension [18].…”

Practice parameter: Anticonvulsant prophylaxis in patients with newly diagnosed brain tumors [RETIRED]

“…Some subgroups of patients with brain tumors (e.g., those with melanoma, hemorrhagic lesions, multiple metastases, tumors located near the Rolandic fissure, slow-growing primary brain tumors) have a higher risk of developing seizures. 4,14,56,[78][79][80][81] There is no evidence that anticonvulsant prophylaxis is more effective in any of these subgroups than in the population of patients with brain tumors as a whole, but prospective, randomized trials tailored specifically to these subgroups should be performed. Does performance of a neurosurgical procedure influence the need for or the efficacy of prophylactic anticonvulsants in patients with brain tumors?…”

Aspectos clínico-epidemiológicos das neoplasias cerebrais na faixa etária pediátrica no Estado da Bahia, Brasil

“…Contudo, crianças com crises parciais (exceto crise parcial benigna), epilepsia de difícil controle e aquelas que apresentam ou passam a apresentar alteração no exame neurológico devem ser investigadas com TC ou RM de crânio 22,23 . Convulsão foi agrupada com hemiparesia porque são sintomas de neoplasia cerebral hemisférica, mas a maioria dos estudos discute convulsão isoladamente ou associada a outro sintoma nem sempre discriminado, o que dificultou a comparação desses dados com outros da literatura.…”