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Seizures in Pediatric Patients With Primary Brain Tumors
Viviane Robert-Boire1, Béatrice Desnous1, Anne Lortie1
1Division of Child Neurology, Department of Pediatrics, Montreal, Québec, Canada.
Insights
Pediatric brain tumors frequently cause seizures. This study identified cortical location, tumor recurrence, and age as seizure risk factors in children, with most achieving seizure freedom after treatment.
Area of Science:
- Pediatric Neurology
- Neuro-oncology
- Epileptology
Background:
- Seizures are a common symptom in children diagnosed with primary central nervous system tumors.
- Understanding seizure characteristics and risk factors is crucial for effective management.
Purpose of the Study:
- To define seizures associated with primary central nervous system tumors in pediatric patients.
- To identify predictive risk factors for seizure occurrence and recurrence in this population.
Main Methods:
- Retrospective review of 348 pediatric patients diagnosed between January 1, 2004, and January 1, 2018.
- Data collected included demographics, tumor characteristics, seizure history, treatment, and outcomes.
- Binomial logistic regression analysis was used to determine seizure risk factors.
Main Results:
- 70 children (20.1%) experienced seizures, with cortical tumors being most common (64.3%).
- Cortical location, tumor recurrence, and age at diagnosis were significant risk factors for seizures.
- Patients with gross total resection were more likely to be weaned off antiepileptic drugs (69.6% vs. 27.3%).
Conclusions:
- This study represents the largest cohort examining tumor-related seizures in children.
- Findings offer new insights into seizure risk based on tumor types and treatment evolution.
Background:
Seizures are one of the most common symptoms of pediatric brain tumors. The purpose of this study was to define seizures related to primary central nervous system tumors and to identify risk factors predictive of seizure occurrence and recurrence.
Methods:
We reviewed the records of children treated from January 1, 2004, to January 1, 2018 and collected data including age, gender, tumor location, histology, extent of initial resection, seizure characteristics, treatment modalities, recurrence, and seizure control. A binomial logistic regression was performed to determine the risk factors of seizure occurrence.
Results:
During the observation period, 348 children were diagnosed with a primary brain tumor. The median age at diagnosis was 7.8 years, and the median follow-up interval was 3.9 years. There were 196 boys (56.3%). In our cohort, a total of 70 children (20.1%) experienced seizures. Most of them (64.3%) had cortical tumors. All patients with dysembryoplastic neuroepithelial tumors and 81.8% of patients with glioneuronal tumors presented seizures. Risk factors associated with an increased risk for seizures included cortical location, tumor recurrence, and age at diagnosis. Thirty-nine (86.7%) patients with seizures at diagnosis were seizure free at last follow-up (Engel 1). Significantly more patients (69.6%) with a gross total resection were withdrawn from their antiepileptic drugs when compared with those with subtotal resection (27.3%, P = 0.007).
Conclusions:
Our study is the largest cohort in children with tumor-related seizures and brings new insight in terms of seizure risk according to tumor types and evolution following treatment.
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