Intractable epilepsy associated with brain tumors in children: surgical modality and outcome

Objects: The aim of this study was to evaluate the role of surgical modalit y in children with brain tumors and intractable epilepsy. Methods: Twenty-t hree patients who were treated for brain tumors and intractable epilepsy be tween January 1985 and March 1998 were retrospectively reviewed. The most c ommon tumors were dysembryoplastic neuroepithelial tumors (n=9), oligodendr ogliomas (n=6), and gangliogliomas (n=5). Six patients exhibited cortical d ysplasia. The mean duration of follow-up was 43.4 months (range 12 to 125 m onths). Seizure outcome was more favorable (Engel's classes I and II) in pa tients with a complete resection of tumor (14/14 vs 6/9 for incomplete rese ction; P<0.05). There was no significant difference in seizure outcome betw een lesionectomy (n=13) and epilepsy surgery (n=10). The likelihood of requ iring postoperative anti-epileptic drugs was not influenced by the extent o f resection or type of surgery. Conclusions: On the basis of this study, we conclude that the complete resection of these tumors can be an appropriate initial treatment for children with brain tumors who experience intractabl e epilepsy.