Seizure control following tumor surgery for childhood cortical low-grade gliomas

J Neurosurg. 1994 Jun;80(6):998-1003. doi: 10.3171/jns.1994.80.6.0998.

Abstract

Detailed preoperative electroencephalographic (EEG) studies are now recommended for children with seizures and cortical tumors to define seizure foci prior to surgery. To develop a historical perspective for better evaluation of results from series reporting tumor removal combined with resection of seizure foci, the authors reviewed seizure outcome in 60 children with seizures and low-grade neoplasms treated consecutively since 1981 by surgical resection without concomitant EEG monitoring or electrocortical mapping. Forty-seven of the 60 tumors were totally or near-totally resected; 45 patients were seizure-free and two were significantly improved 1 year following surgery. Of the 50 children in this series with more than five seizures prior to surgery, 36 were seizure-free, two were significantly improved, and 12 were not improved. Factors associated with poor seizure control included a parietal tumor location, a partial tumor resection, and a history of seizures for more than 1 year prior to surgery. The children at highest risk for poor seizure control at 2 years had experienced seizures for more than 1 year prior to surgery and had undergone partial resection of their parietal low-grade glial tumors or gangliogliomas. In contradistinction, the best seizure control was seen in patients with totally resected low-grade gliomas or gangliogliomas who had experienced seizures for less than 1 year (concordance rates for being seizure-free ranged from 78% to 86%). Long-term seizure control remained excellent. These results suggest that seizure control can be obtained 2 years following tumor surgery in the majority of children with presumed tumors after extensive tumor resection without concomitant EEG monitoring or electrocortical mapping.

MeSH terms

  • Adolescent
  • Adult
  • Brain Mapping
  • Brain Neoplasms / complications
  • Brain Neoplasms / surgery*
  • Cerebral Cortex*
  • Child
  • Child, Preschool
  • Electroencephalography
  • Female
  • Follow-Up Studies
  • Ganglioglioma / complications
  • Ganglioglioma / surgery
  • Glioma / complications
  • Glioma / surgery*
  • Humans
  • Infant
  • Male
  • Prognosis
  • Regression Analysis
  • Risk Factors
  • Seizures / diagnosis
  • Seizures / etiology
  • Seizures / surgery*