Abstracts

Rationale: We investigated the prevalence, onset, characteristics and long term course of epilepsy disease in children with diagnosed brain tumors. Methods: We reviewed the medical records of children with diagnosed brain tumor, who underwent surgery during 2004-2014 at the Hadassah Medical Center. The primary outcome measure was the timing of epilepsy onset. All patients with epilepsy were invited to a clinical visit that included a neurological exam. Neurological outcome was assessed using the Glasgow Outcome Scale (GOS). Postoperative seizure outcome was classified according to the Engel system. Results: The mean follow up was 49 months. Of 128 patients included in the study, 44 (34%) had seizures; 23 (18%) developed epilepsy after surgery. Of the 30 epilepsy patients who survived, 21 (70%) are in Engel class I and 13% Engel class II. Forty-five percent of the children are classified as GOS 5. Children who developed epilepsy after surgery were more likely to be in GOS 1-2 than were those who had seizures before surgery (P=0.0173). Children with seizures were more likely to have cortical tumors, and less likely to have tumors of the posterior fossa (P < 0.001). Children who underwent gross total resection were less likely to have epilepsy (P < 0.001). Conclusions: We show a high incidence of epilepsy in the late course of pediatric brain tumor disease. In the long term, seizure outcome was excellent. However, postsurgical onset of epilepsy was associated with a less favorable neurological outcome. This suggests that the timing of seizure onset may have a prognostic value. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.