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Updated: Dec 25, 2025
Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Seizures following surgery for supratentorial extratemporal low-grade tumors in children: a multicenter retrospective
Jonathan Roth1, Or Bercovich1,2, Ashton Roach3
11Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University.
Objective:
Resection of brain tumors may lead to new-onset seizures but may also reduce seizure rates in patients presenting with seizures. Seizures are seen at presentation in about 24% of patients with brain tumors. For lesional epilepsy in general, early resection is associated with improved seizure control. However, the literature is limited regarding the occurrence of new-onset postoperative seizures, or rates of seizure control in those presenting with seizures, following resections of extratemporal low-grade gliomas (LGGs) in children.
Methods:
Data were collected retrospectively from 4 large tertiary centers for children (< 18 years of age) who underwent resection of a supratentorial extratemporal (STET) LGG. The patients were divided into 4 groups based on preoperative seizure history: no seizures, up to 2 seizures, more than 2 seizures, and uncontrolled or refractory epilepsy. The authors analyzed the postoperative occurrence of seizures and the need for antiepileptic drugs (AEDs) over time for the various subgroups.
Results:
The study included 98 children. Thirty patients had no preoperative seizures, 18 had up to 2, 16 had more than 2, and 34 had refractory or uncontrolled epilepsy. The risk for future seizures was higher if the patient had seizures within 1 month of surgery. The risk for new-onset seizures among patients with no seizures prior to surgery was low. The rate of seizures decreased over time for children with uncontrolled or refractory seizures. The need for AEDs was higher in the more active preoperative seizure groups; however, it decreased with time.
Conclusions:
The resection of STET LGGs in children is associated with a low rate of postoperative new-onset epilepsy. For children with preoperative seizures, even with uncontrolled epilepsy, most have a significant improvement in the seizure activity, and many may be weaned off their AEDs.
Insights
Brain tumor resection in children has a low risk of new seizures. Most children with prior seizures, even refractory epilepsy, experience improved seizure control after surgery and may reduce antiepileptic drug needs.
Area of Science:
- Pediatric Neurosurgery
- Epileptology
- Pediatric Oncology
Background:
- Brain tumors can cause new-onset seizures or worsen existing ones.
- Extratemporal low-grade gliomas (LGGs) in children present unique challenges regarding seizure control post-resection.
- Limited data exists on postoperative seizures and seizure control after extratemporal LGG resection in pediatric patients.
Purpose of the Study:
- To investigate the incidence of new-onset seizures after surgical resection of supratentorial extratemporal low-grade gliomas (STET LGGs) in children.
- To evaluate seizure control rates and the need for antiepileptic drugs (AEDs) in pediatric patients with varying preoperative seizure histories undergoing STET LGG resection.
Main Methods:
- Retrospective analysis of 98 pediatric patients (<18 years) from 4 tertiary centers who underwent STET LGG resection.
- Patients were stratified into four groups based on preoperative seizure frequency: none, up to 2, more than 2, and refractory epilepsy.
- Postoperative seizure occurrence and AED requirements were analyzed over time for each subgroup.
Main Results:
- The risk of new-onset seizures post-surgery was low in children without prior seizures.
- Patients with seizures within one month of surgery had a higher risk of future seizures.
- A significant decrease in seizure rates and AED needs was observed over time for children with previously uncontrolled or refractory epilepsy.
Conclusions:
- Resection of STET LGGs in children is associated with a low risk of new-onset postoperative epilepsy.
- The majority of pediatric patients with preoperative seizures, including those with refractory epilepsy, show substantial improvement in seizure activity following resection.
- Many children may be successfully weaned off antiepileptic drugs after successful tumor resection.
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