Epileptic seizures during follow-up of patients treated for primary brain tumors.
OBJECTIVE
To determine the presentation, incidence, and severity of seizures in follow-up of patients treated for primary brain tumors.


METHODS
A total of 234 consecutive patients attending an outpatient clinic for chemotherapy of a supratentorial brain tumor were examined.


RESULTS
Seizures occurred in 183 patients. All patients with epilepsy were on antiepileptic drugs (AEDs). Compared with patients without epilepsy, patients with epilepsy had a higher proportion of low-grade gliomas (p < 0.001) and cortical tumor location (p < 0.001). In 158 (86.4%) patients, seizures were an early manifestation of the disease, and epilepsy developed in only 25 (13.6%) individuals in the course of the malignant disease. Generalization occurred in 50% of early seizures, but in only 19.1% of patients with seizures persisting after the initiation of AEDs and specific antitumor therapies. The reduction in seizure generalization was significant (p = 0.001). Despite AED and various antitumor treatments, one-half of the patients had a seizure within 1 month and two-thirds within 3 months before the last evaluation.


CONCLUSIONS
Most tumor-related seizures first appear early in the course of disease, usually as a presenting manifestation. Antiepileptic drugs combined with specific antitumor treatments significantly reduce the rate of seizure generalization. However, most patients continue to have focal epilepsy during follow-up.
Hildebrand
Jerzy
J
Fédération de Neurologie Mazarin, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. hildebrand@skynet.be
Lecaille
Cristel
C
Perennes
Joëlle
J
Delattre
Jean-Yves
JY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology*; D015984:Causality; D002540:Cerebral Cortex / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D004338:Drug Combinations; D004351:Drug Resistance / Q000502:physiology; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000706:statistics & numerical data; D015173:Supratentorial Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome
D000927:Anticonvulsants; D000970:Antineoplastic Agents; D004338:Drug Combinations