Seizures in children and adolescents with high-grade glioma: a retrospective, monocentric analysis

Seizures are a common symptom of pediatric high-grade gliomas (pHGG). This study aimed to characterize these seizures in the context of the underlying tumor disease in this age group.

We retrospectively analysed the medical files of children and adolescents treated in the University Hospital Erlangen for high-grade glioma between January 2000 and May 2021 and collected data including age, sex, tumor location, histopathology, extent of initial resection, tumor recurrence, seizure characteristics, EEG findings, seizure and oncological treatment, and seizure control.

Our study included 39 children (14 boys, 35.9 %) diagnosed with high-grade glioma. The median age at diagnosis was 8.5 years (range 0-17 years), and the median follow-up interval was 353 days (range 28-9146 days). 16 children had supratentorial and 23 infratentorial gliomas. 17 children (43.6 %) experienced seizures of which 10/17 (58.8 %) had supratentorial tumors. 5 of these children (20 % of all patients with epilepsy and 12.8 % of the entire cohort) presented with seizures as the first sign. 11/17 children (64.7 %) had recurrent seizures. Status epilepticus occurred in one child (2.6 %). EEG was performed in 29 patients with interictal epileptiform discharges in 4/29 (13.8 %).

Present data show a high incidence of seizures in pHGG associated with supratentorial but also infratentorial location. The pediatric incidence was comparable to that in adults. The majority of the children developed repetitive seizures.