title: Brain tumors in children with refractory seizures—a long-term follow-up study after epilepsy surgery.
abstract: OBJECTIVE
  Epilepsy surgery is an established treatment option for medically refractory epilepsy. Brain tumors, besides dysplasias, vascular malformations, and other lesions, can cause refractory epilepsy. Long-term epilepsy-associated brain tumors, even though mostly benign, are neoplastic lesions and thus have to be considered as both epileptic and oncological lesions.
  
  
  METHODS
  We retrospectively analyzed epileptological and oncological long-term follow-up (FU) in pediatric patients who underwent brain surgery for refractory epilepsy and whose histology showed a tumor as underlying cause (n = 107, mean FU 119 months).
  
  
  RESULTS
  At last available outcome, 82.2% of patients were seizure free (International League Against Epilepsy (ILAE) class 1) and seizure outcome was stable over more than 14 years. Fifty-four percent of the patients were without anti-epileptic drugs (AEDs) at last available outcome; 96.2% of the tumors were classified WHO grade I and II and 3.7% were malignant (WHO grade III). Adjuvant treatment was administered in 5.7%; 2.9% had relapse and one patient died (tumor-related mortality = 1.4%). After surgery, 91% of the patients attended regular school/university and/or professional training.
  
  
  CONCLUSIONS
  This study shows that epileptological outcome within this group is promising and stable and oncological outcome has a very good prognosis. However, oncological FU must not be dismissed as a small percentage of patients who suffer from malignant tumors and adjuvant treatment, relapse, and mortality have to be considered.
authors.affiliation: Department of Neurosurgery, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany, Caroline.Wessling@ukb.uni-bonn.de.
authors.forename: Caroline
authors.initials: C
authors.lastname: Wessling
authors.forename: Susanne
authors.initials: S
authors.lastname: Bartels
authors.forename: Robert
authors.initials: R
authors.lastname: Sassen
authors.forename: Jan-Christoph
authors.initials: JC
authors.lastname: Schoene-Bake
authors.forename: Marec
authors.initials: M
authors.lastname: von Lehe
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome