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Utility of Epilepsy Surgery in Survivors of Childhood CancerFunding This work was supported in part by the American Lebanese Syrian Associated Charities (ALSAC) and the National Cancer Institute grant (P30 CA021765) (St. Jude Cancer Center Support Grant). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Resection of an epileptogenic focus improves seizure control in patients with drug-resistant epilepsy. There is little data available on usefulness of epilepsy surgery in childhood cancer survivors with drug-resistant epilepsy. To learn about seizure outcome after epilepsy surgery in childhood cancer survivors, we retrospectively reviewed charts of 42 children who were referred to an epilepsy center for surgical evaluation. Sixteen children (38%) were offered epilepsy surgery and 10 consented. Seizure outcome was classified based on International League Against Epilepsy outcome scale. All 10 children were having multiple seizures a month on therapeutic doses of three antiepilepsy drugs (AEDs). At a median follow-up of 5.6 years after epilepsy surgery, three children had class 1 outcome (no seizures), four had class 3 outcome (1–3 seizure days/year), and three had class 4 outcome (≥ 50% reduction in seizure frequency). One child was off AEDs, seven were on a single AED, and two were on three AEDs at their last follow-up. Epilepsy surgery had low morbidity and improved seizure control in childhood cancer survivors with drug-resistant epilepsy. Childhood cancer survivors with drug-resistant epilepsy should be referred to an epilepsy center for a higher level of care.
Received: 12 August 2020
Accepted: 24 February 2021
14 April 2021 (online)
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- 1 Kwan P, Arzimanoglou A, Berg AT. et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010; 51 (06) 1069-1077 [Erratum in Epilepsia 2010;51:1922]
- 2 Jobst BC, Cascino GD. Resective epilepsy surgery for drug-resistant focal epilepsy: a review. JAMA 2015; 313 (03) 285-293
- 3 Khan RB, Hunt DL, Boop FA. et al. Seizures in children with primary brain tumors: incidence and long-term outcome. Epilepsy Res 2005; 64 (03) 85-91
- 4 Neal A, Kwan P, O'Brien TJ, Buckland ME, Gonzales M, Morokoff A. IDH1 and IDH2 mutations in postoperative diffuse glioma-associated epilepsy. Epilepsy Behav 2018; 78: 30-36
- 5 Beaumont A, Whittle IR. The pathogenesis of tumour associated epilepsy. Acta Neurochir (Wien) 2000; 142 (01) 1-15
- 6 Akeret K, Serra C, Rafi O. et al. Anatomical features of primary brain tumors affect seizure risk and semiology. Neuroimage Clin 2019; 22: 101688
- 7 Robertson FC, Ullrich NJ, Manley PE, Al-Sayegh H, Ma C, Goumnerova LC. The impact of intraoperative electrocorticography on seizure outcome after resection of pediatric brain tumors: a cohort study. Neurosurgery 2019; 85 (03) 375-383
- 8 Porter KR, McCarthy BJ, Freels S, Kim Y, Davis FG. Prevalence estimates for primary brain tumors in the United States by age, gender, behavior, and histology. Neuro-oncol 2010; 12 (06) 520-527
- 9 Tian AG, Edwards MS, Williams NJ, Olson DM. Epilepsy surgery following brain tumor resection in children. J Neurosurg Pediatr 2011; 7 (03) 229-234
- 10 Titus JB, Lee A, Kasasbeh A. et al. Health-related quality of life before and after pediatric epilepsy surgery: the influence of seizure outcome on changes in physical functioning and social functioning. Epilepsy Behav 2013; 27 (03) 477-483
- 11 Lamberink HJ, Otte WM, Blümcke I, Braun KPJ. European Epilepsy Brain Bank writing group, study group, European Reference Network EpiCARE. Seizure outcome and use of antiepileptic drugs after epilepsy surgery according to histopathological diagnosis: a retrospective multicentre cohort study. Lancet Neurol 2020; 19 (09) 748-757