Epileptic Seizures and Supratentorial Brain Tumors in Children

Brain tumors represent about one third of the pediatric tumors. Epilepsy is overall associated with supratentorial brain tumors, that prevail in children under 3 years and over 10 years. Prevalence of seizures as first tumor symptom is 15–20%. In children under the 3 years of life, epilepsy is more frequent (until 70%), it can persists after the surgical intervention and in some cases an epileptic encephalopathy occurs. Epilepsy can began after surgery in other cases (10–40%), as a consequence of brain damage. Moreover, brain tumors are in a relevant percentage of cases (26–50%) the cause of a drug-resistant epilepsy, that can be successfully treated by surgery. The post surgical evolution is more favorable for patients with some particular tumor types (DNT, gangliogliomas). Pharmacological therapy of the epilepsy related with tumors is difficult, for an high frequency of side effects and of interactions with chemotherapy. The new AEDs are particularly promising not only for the favorable effect, but also for the lower incidence of side effects and of interactions.