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Seizures as the clinical presenting symptom in children with brain tumors

Aviva Fattal-Valevski1, Noam Nissan, Uri Kramer

  • 1Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Journal of Child Neurology
|May 26, 2012
PubMed

Insights

Pediatric brain tumors can present as seizures, even with normal exams. Early imaging is crucial for diagnosis, as treatment often leads to seizure freedom.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Clinical Oncology

Background:

  • Seizures are a common presenting symptom in pediatric brain tumors.
  • Diagnostic delays can occur despite normal neurological examinations and electroencephalography (EEG).

Purpose of the Study:

  • To review clinical and surgical outcomes of pediatric brain tumors presenting with seizures.
  • To analyze the diagnostic gap and long-term seizure control post-surgery.

Main Methods:

  • Retrospective analysis of 367 pediatric patients treated for brain tumors (1996-2007).
  • Focus on clinical presentation, diagnostic challenges, and 2-year postoperative seizure follow-up.

Main Results:

  • 57 of 367 children presented with seizures, predominantly focal.
  • Normal neurological examination (77.8%) and EEG (37.5%) were common.
  • Seizure freedom was achieved in 77.6% postoperatively.
  • Favorable outcomes linked to infrequent seizures, response to antiepileptic drugs, and hemispheric location.

Conclusions:

  • Normal neurological exams, EEG, and initial response to antiepileptic drugs should not rule out brain tumors in children with seizures.
  • Consider broader imaging indications for pediatric seizures to reduce diagnostic delays.

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