Long-term sequelae in children treated for brain tumors: impairments, disability, and handicap

Sixty-one long-term survivors, treated for brain tumors in childhood, were evaluated in term of neurological impairments, disability, and handicap. Thirty-eight patients (pts) (62%) had at least one impairment. Visual impairment was detected in 14 pts (24%), associated with recurrence (p = .012). Thirty-four patients (56%) had motor impairment, associated with sex (female) in irradiated patients; 13 (21%) had epilepsy, associated with supratentorial tumor site (p = .001). The same number of patients had brain atrophy; risk factors were hydrocephalus at diagnosis and perioperative complications. Sixteen patients (30%) had IQ score < 80, associated with young age at first treatment (p = .006) and recurrence (p = .043). Twenty-seven out of 61 of our patients (44%) were disabled: 12 mildly, 14 moderately, and 1 severely. Epilepsy was the most important risk factor for disability. Cognitive impairment, motor impairment, and epilepsy were associated with employment (43%); cognitive impairment was also associated with education.