Skip to main content
Springer Nature Link
Log in

Epilepsy surgery for pediatric low-grade gliomas of the cerebral hemispheres: neurosurgical considerations and outcomes

  • Special Annual Issue
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Introduction

Pediatric low-grade tumors are found in roughly 1–3 % of patients with childhood epilepsy; seizures associated with these tumors are often medically refractory and often present a significant morbidity, greater than the presence of the tumor itself.

Discussion

The unique morbidity of the seizures often requires an epilepsy surgical approach over a standard oncologic resection to achieve a reduction in morbidity for the child. Multiple quality-of-life studies have shown that unless a patient is seizure-free, they remain disabled throughout their life; the best way to achieve this in our patient population is with a multidisciplinary team approach with treatment goals focusing primarily on the epilepsy.

Conclusion

In those patients treated with gross total resection, roughly 80 % will have an Engel class I outcome and 90 % will achieve some reduction in seizure frequency with a significant improvement in quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Wray CD, McDaniel SS, Saneto RP, Novotny EJ, Ojemann JG (2012) Is postresective intraoperative electrocorticography predictive of seizure outcomes in children? J Neurosurg Pediatrics 9:546–551

    Article  Google Scholar 

  2. Ceddia A, Di Rocco C, Iannelli A (1993) Epilepsy and low grade gliomas in pediatric neurosurgery. J Neurosurg Sci 37(2):91–95

    CAS  PubMed  Google Scholar 

  3. Fattal-Valevski A, Nissan N, Kramer U, Constantini S (2013) Seizures as the clinical presenting symptom in children with brain tumors. J Child Neurol 28:292

    Article  PubMed  Google Scholar 

  4. Khajavi K, Comair YG, Wyllie E, Palmer J, Morris HH, Hahn JF (1999) Surgical management of pediatric tumor-associated epilepsy. J Child Neurol 14(1):15–25

    Article  CAS  PubMed  Google Scholar 

  5. Ranger A, Diosy D (2015) Seizures in children with brain tumours—epidemiology, significance, management, and outcomes. In: Lichtor T (ed) Molecular considerations and evolving surgical management issues in the treatment of patients with a brain tumor. InTech, pp. 197–234. doi:10.5772/58961. Available from: http://www.intechopen.com/books/molecular-considerations-and-evolving-surgical-managementissues-in-the-treatment-of-patients-with-a-brain-tumor/seizures-in-children-with-brain-tumoursepidemiology-significance-management-and-outcomes

  6. Ullrich NJ, Pomeroy SL, Kapur K, Manley PE, Goumnerova LC, Loddenkemper T (2015) Incidence, risk factors, and longitudinal outcome of seizures in long-term survivors of pediatric brain tumors. Epilepsia 56(10):1599–1604

    Article  PubMed  Google Scholar 

  7. Williams BA, Abbott KJ, Manson JI (1992) Cerebral tumors in children presenting with epilepsy. J Child Neurol 7(3):291–294

    Article  CAS  PubMed  Google Scholar 

  8. Kahlenberg CA, Fadul CE, Roberts DW, Thadani VM, Bujarski KA, Scott RC, Jobst BC (2012) Seizure prognosis of patients with low-grade tumors. Seizure 21:540–545

    Article  PubMed  Google Scholar 

  9. Khan RB, Hunt DL, Boop FA, Sanford RA, Merchant TE, Gajjar A, Kun LE (2005) Seizures in children with primary brain tumors: incidence and long-term outcome. Epilepsy Res 64:85–91

    Article  PubMed  Google Scholar 

  10. Rudà R, Trevisan E, Soffietti R (2010) Epilepsy and brain tumors. Curr Opin Oncol 22:611–620

    Article  PubMed  Google Scholar 

  11. Shady JA, Black PM, Kupsky WJ, Tarbell NJ, Scott RM, Leong T, Holmes G (1994) Seizures in children with supratentorial astroglial neoplasms. Pediatr Neurosurg 21(1):23–30

    Article  CAS  PubMed  Google Scholar 

  12. You G, Sha Z, Jiang T (2012) The pathogenesis of tumor-related epilepsy and its implications for clinical treatment. Seizure 21:153–159

    Article  PubMed  Google Scholar 

  13. Ranger A, Diosy D (2015) Seizures in children with dysembryoplastic neuroepithelial tumors of the brain—a review of surgical outcomes across several studies. Childs Nerv Syst 31:847–855

    Article  PubMed  PubMed Central  Google Scholar 

  14. Giulioni M, Galassi E, Zucchelli M, Volpi L (2005) Seizure outcome of lesionectomy in glioneuronal tumors associated with epilepsy in children. J Neurosurg (Pediatrics 3) 102:288–293

    Article  Google Scholar 

  15. Hu WH, Ge M, Zhang K, Meng F, Zhang J (2012) Seizure outcome with surgical management of epileptogenic ganglioglioma: a study of 55 patients. Acta Neurochir 154:855–861

    Article  PubMed  Google Scholar 

  16. Ogiwara H, Nordli DR Jr, DiPatri AJ Jr, Alden TD, Bowman RM, Tomita T (2010) Pediatric epileptogenic gangliogliomas: seizure outcome and surgical results. J Neurosurg Pediatrics 5:271–276

    Article  Google Scholar 

  17. Englot DJ, Berger MS, Barbaro NM, Chang EF (2012) Factors associated with seizure freedom in the surgical resection of glioneuronal tumors. Epilepsia 53(1):51–57

    Article  PubMed  Google Scholar 

  18. Englot DJ, Han SJ, Berger MS, Barbaro NM, Chang EF (2012) Extent of surgical resection predicts seizure freedom in low-grade temporal lobe brain tumors. Neurosurg 70:921–928

    Article  Google Scholar 

  19. Uliel-Sibony S, Kramer U, Fried I, Fattal-Valevski A, Constantini S (2011) Pediatric temporal low-grade glial tumors: epilepsy outcome following resection in 48 children. Childs Nerv Syst 27:1413–1418

    Article  PubMed  Google Scholar 

  20. Kargiotis O, Markoula S, Kyritsis AP (2011) Epilepsy in the cancer patient. Cancer Chemother Pharmacol 67(3):489–501

    Article  CAS  PubMed  Google Scholar 

  21. Steinbok P, Gan PYC, Connolly MB, Carmant L, Sinclair DB, Rutka J, Griebel R, Aronyk K, Hader W, Ventureyra E, Atkinson J (2009) Epilepsy in the first 3 years of life: a Canadian survey. Epilepsia 50(6):1442–1449

    Article  PubMed  Google Scholar 

  22. Fallah A, Weil AG, Sur S, Miller I, Jayakar P, Morrison G, Bhatia S, Ragheb J (2015) Epilepsy surgery related to pediatric brain tumors: Miami Children’s Hospital experience. J Neurosurg Pediatr 16:675–680

    Article  PubMed  Google Scholar 

  23. Wells EM, Gaillard WD, Packer RJ (2012) Pediatric brain tumors and epilepsy. Semin Pediatr Neurol 19:3–8

    Article  PubMed  Google Scholar 

  24. Cataltepe O, Turanli G, Yalnizoglu D, Topçu M, Akalan N (2005) Surgical management of temporal lobe tumor-related epilepsy in children. J Neurosurg (Pediatrics 3) 102:280–287

    Article  Google Scholar 

  25. Khan RB, Boop FA, Onar A, Sanford RA (2006) Seizures in children with low-grade tumors: outcome after tumor resection and risk factors for uncontrolled seizures. J Neurosurg (Pediatrics 6) 104:377–382

    Article  Google Scholar 

  26. Lombardi D, Marsh R, de Tribolet N (1997) Low grade glioma in intractable epilepsy: lesionectomy versus epilepsy surgery. Act Neurochir Suppl 68:70–74

    CAS  Google Scholar 

  27. Beaumont A, Wittle IR (2000) The pathogenesis of tumor associated epilepsy. Acta Neurochir 142(1):1–15

    Article  CAS  PubMed  Google Scholar 

  28. Buckingham SC, Campbell SL, Haas BR, Montana V, Robel S, Ogunrinu T, Sontheimer H (2011) Glutamate release by primary brain tumors induces epileptic activity. Nat Med 17(10):1269–1274

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Rudà R, Bello L, Duffau H, Soffietti R (2012) Seizures in low-grade gliomas: natural history, pathogenesis, and outcome after treatments. Neuro-Oncology 14:iv55–iv64

    Article  PubMed  PubMed Central  Google Scholar 

  30. Shamil MF, Fric-Shamil EC, Benoit BG (2009) Brain tumors and epilepsy: pathophysiology of peritumoral changes. Neurosurg Rev 32(3):275–284

    Article  Google Scholar 

  31. Berger MS, Ghatan S, Haglund MM, Dobbins J, Ojemann GA (1993) Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection. J Neurosurg 79:62–69

    Article  CAS  PubMed  Google Scholar 

  32. Cossu M, Dalila F, Bramerio M, Galli C, Gozzo F, Pelliccia V, Casaceli G, Tassi L, Lo Russo G (2013) Epilepsy surgery of focal cortical dysplasia-associated tumors. Epilepsia 54(Suppl 9):115–122

    Article  PubMed  Google Scholar 

  33. Crino P (2015) Focal cortical dysplasia. Semin Neurol 35(3):201–208

    Article  PubMed  Google Scholar 

  34. Santos MV, de Oliveira RS, Machado HR (2014) Approach to cortical dysplasia associated with glial and glioneuronal tumors (FCD type IIIb). Childs Nerv Syst 30(11):1869–1874

    Article  PubMed  Google Scholar 

  35. Blume WT, Girvin JP, Kaufmann JC (1982) Childhood brain tumors presenting as chronic uncontrolled focal seizure disorders. Ann Neurol 12:538–541

    Article  CAS  PubMed  Google Scholar 

  36. Vuori K, Kankaanranta L, Häkkinen AM, Gally E, Valanne L, Granström M, Joensuu H, Blomstedt G, Paetau A, Lundbom N (2004) Low-grade gliomas and focal cortical developmental malformations: differentiation with proton MR spectroscopy. Radiology 230:703–708

    Article  PubMed  Google Scholar 

  37. Wieser HG, Blume WT, Fish D, Goldensohn E, Hufnagel A, King JD, Sperling MR, Lüders H (2001) Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia 42(2):282–286

    CAS  PubMed  Google Scholar 

  38. Jennings MT, Frenchman M, Shehab T, Johnson MD, Creasy J, LaPorte K, Dettbarn WD (1995) Gliomatosis cerebri presenting as intractable epilepsy during early childhood. J Child Neurol 10(1):37–45

    Article  CAS  PubMed  Google Scholar 

  39. Richard HT, Harrison JF, Abel TW, Maertens P, Martino AM, Sosnowski JS (2010) Pediatric gliomatosis cerebri mimicking acute disseminated encephalomyelitis. Pediatrics 126(2):e479–e482

    Article  PubMed  Google Scholar 

  40. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820

    Article  PubMed  Google Scholar 

  41. Khan RB, Onar A (2006) Seizure recurrence and risk factors after antiepilepsy drug withdrawal in children with brain tumors. Epilepsia 47(2):375–379

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University of Tennessee Health Science Center, 847 Monroe Ave., Suite 427, Memphis, TN, 38163, USA

    Matthew T. Brown & Frederick A. Boop

  2. Semmes-Murphey Clinic, 6325 Humphreys Blvd, Memphis, TN, 38120, USA

    Frederick A. Boop

Authors
  1. Matthew T. Brown
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Frederick A. Boop
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Matthew T. Brown.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brown, M.T., Boop, F.A. Epilepsy surgery for pediatric low-grade gliomas of the cerebral hemispheres: neurosurgical considerations and outcomes. Childs Nerv Syst 32, 1923–1930 (2016). https://doi.org/10.1007/s00381-016-3162-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-016-3162-7

Keywords