Seizure freedom may be achieved with surgery in kids with refractory epilepsy, brain tumours

Epilepsy surgery appears beneficial for children with refractory epilepsy and high-grade central nervous system tumours, with a multicentre study showing that the procedure results in seizure freedom in most patients.

Researchers retrospectively examined epilepsy surgery outcomes in two cohorts of patients younger than 25 years who had high-grade brain tumours (World Health Organization grades III and IV): (1) those who underwent the procedure after tumour resection (n=14) and (2) those initially suspected of low-grade lesions but diagnosed with high-grade brain tumours after the procedure (n=11).

Results showed that 80 percent of patients overall achieved seizure freedom 1 year after epilepsy surgery, including 71 percent in cohort 1 and 91 percent in cohort 2. Furthermore, 84 percent of patients were free of disabling seizures (Engel IA–D) after a median follow-up period of 4.3 years.

In terms of safety, no deaths attributable to epilepsy surgery were reported. However, 32 percent of children had persistent morbidity, such as motor dysfunction, visual impairment, persistent seizures, cognitive deficits, and hydrocephalus.

The findings suggest that epilepsy surgery, despite being effective in the population of youths with medically refractory epilepsy and high-grade central nervous system tumours, is rarely considered.  Given the potential for seizure freedom, early epilepsy surgery should be considered, according to the researchers.