Epilepsy and primary cerebral tumours

Although the association of epilepsy with cerebral tumours is well recognized, the reported incidence of seizures and relationship to tumour pathology varies significantly. This study assessed retrospectively the incidence of seizures, relationship to tumour pathology, natural history of epilepsy and prognostic significance of presentation with a seizure in 120 consecutive adults with histologically proven primary cerebral hemisphere tumours including meningiomas. 52% had a seizure and most were at presentation. Seizures were more common with anaplastic astrocytoma (AA) (18 23 ) than glioblastoma multiforme (21 56 ) (p = 0.001) and seizure occurrence was associated with cortical invasion. 52% of meningioma patients had a seizure. Seizures recurred in 34%, more frequently with glioma (19 of 46) than meningioma (1 of 15) (p < 0.05). Patients with AA presenting with a seizure had a longer survival (28 months) than patients without seizure (8 months) (p = 0.05 one sided). In conclusion, seizures are a common complication of cerebral tumours, usually at presentation and correlate with tumour pathology. A seizure at presentation in AA correlates with longer survival.