Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Specific features of epilepsy in children with brain tumors

https://doi.org/10.14412/2074-2711-2015-1S-54-59

Full Text:

Abstract

Objective: to study the specific features of epilepsy in children and adolescents with brain tumors and to define the optimal tactics of management and antiepileptic therapy after surgical treatment.
Patients and methods. Sixty-one patients aged 5 months to 15 years were examined. All the patients were diagnosed as having a brain tumor found in the presence of symptomatic epilepsy. They were all followed up for 5 years postsurgery or during their lifetime (in case of death). Comprehensive examination encompassing the assessment of history data and concomitant complaints, brain magnetic resonance imaging, video-EEC monitoring, and the neurological status (the presence of cognitive impairments and eye ground changes) was done in all the cases. The probability of epileptic seizures in the clinical presentation of the disease, their semiology, and frequency were studied.
Results and discussion. Epileptic seizures were the major complaint in all the patients at the first visit to their doctor. The disease occurred with status epilepticus in 9% of the patients. Different types of generalized seizures were more common (53%; p≥0.05).
The tumor was located above the tentorium of the cerebellum in most examinees (77%) and beneath it in the others (23%; p≤0.05).
The significant clinical sign of a brain tumor in the epileptic children is focal neurological symptoms (72% of the cases). MRI was performed in children who had no focal neurological symptoms in the late periods.
There was cerebrospinal fluid hypertension in 51% of the patients (p≥0.05) and cognitive impairments in 33% (p<0.05). The maximum number (74%) of children with psycho-speech disorders and cognitive impairments were registered in the age group of 7–15 years. Eye ground changes characteristic of intracranial hypertension were identified in 19 epileptic children; they occurred in 27 patients more than 1 year after the onset of seizures. The late (few months-to-14 years) diagnosis of a brain tumor was stated in children with epileptic seizures. The diagnosis was established in patients with a tumor in the cerebral hemispheres in the later periods. The leading symptom in these children was epileptic seizures and EEG changes. The changes detectable by video-EEG monitoring with sleep inclusion were shown to be of diagnostic value. 

About the Authors

G. V. Kalmykova
Department of Nervous System Diseases and Rehabilitation Medicine, Faculty of Medicine, Belgorod State National Research University, Regional Children's Clinical Hospital, Belgorod, Russia; 85, Pobeda St., Belgorod 308015;
Russian Federation


A. F. Neretina
N.N. Burdenko Voronezh State Medical Academy, Ministry of Health of Russia, Voronezh, Russia; 10, Studencheskaya St., Voronezh 394036
Russian Federation


Zh. Yu. Chefranova
Department of Nervous System Diseases and Rehabilitation Medicine, Faculty of Medicine, Belgorod State National Research University, Regional Children's Clinical Hospital, Belgorod, Russia; 85, Pobeda St., Belgorod 308015;
Russian Federation


References

1. Медведев МИ, Володин НН, Горбунов АВ и др. Парциальные судороги – клиническая манифестация анапластической астроцитомы в раннем возрасте. Российский вестник перинатологии и педиатрии. 2000;(1):38–40. [Medvedev MI, Volodin NN, Gorbunov AV, et al. Partial seizures – clinical manifestation of anaplastic astrocytomas at an early age. Rossiiskii vestnik perinatologii i pediatrii. 2000;(1):38–40. (In Russ.)].

2. Гузева ВИ, Гузева ОВ, Гузева ВВ. Основные этиопатогенетические факторы и их значение в клинике и прогнозе эпилепсии у детей. В кн.: Эпилепсия. Санкт-Петербург: НИПНИ им. В.М. Бехтерева; 2010. С. 263. [Guzeva VI, Guzeva OV, Guzeva VV. The main etiopathogenetic factors and their importance in the clinic and prognosis of epilepsy in children. In: Epilepsiya [Epilepsy]. Saint-Petersburg: NIPNI im. V.M. Bekhtereva; 2010. P. 263.]

3. Halperin EC, Conctine LS, Tarbell NJ, et al. Pediatric radioation oncology. Philadelphia: Lippincott Williams and Wilkins; 2010. 512 p.

4. Богданов ЭИ, Хузина ГР. Мальформации головного мозга и эпилепсия. В кн.: Эпилептология в медицине XXI века. Москва; 2009. С. 219–25. [Bogdanov EI, Khuzina GR. Brain malformations and epilepsy. In: Epileptologiya v meditsine XXI veka [Epileptology in medicine of the XXI century]. Moscow; 2009. P. 219–25].

5. Крамер Г. Семиология приступов. В кн.: Эпилептология в медицине XXI века. Москва; 2009. C. 133–9. [Kramer G. Semiology of seizures. In: Epileptologiya v meditsine XXI veka [Epileptology in medicine of the XXI century]. Moscow; 2009. P. 133–9].

6. Айвазян СО. Эволюция припадков и электроэнцефалографических характеристик при ранних формах эпилепсии. Диссертация на соискание ученой степени кандидата медицинских наук. Москва; 2000. C.118 [Aivazyan SO. Evolution of seizures and electroencephalographic characteristics with early forms of epilepsy. The dissertation on competition of a scientific degree of candidate of medical Sciences. Moscow; 2000. P. 118].

7. Авакян ГН, Анисимова АВ, Айвазян СО, Генералов ВО. Видео-ЭЭГ мониторинг в современной диагностике и контроле эпилепсии: Пособие для врачей. Под ред. ЕИ Гусева. Москва: РГМУ; 2006. [Avakyan GN, Anisimova AV, Aivazyan SO, Generalov VO. Video-EEG monitoring v sovremennoi diagnostike i kontrole epilepsii: posobie dlya vrachei [Video-EEG monitoring in the modern diagnosis and control of epilepsy: a manual for physicians]. Gusev EI, editor. Moscow: RGMU; 2006.]

8. Белоглазов ТА, Берснев ВП. Значимость ЭЭГ при супратенториальных опухолях у детей. В кн.: 3-й съезд нейрохирургов России: Материалы съезда. Санкт-Петербург; 2002. С. 549–50. [Beloglazov TA, Bersnev VP. The significance of EEG with supratentorial tumors in children. In: 3-i s’ezd neirokhirurgov Rossii: Materialy s’ezda [3rd Congress of neurosurgeons of Russia: Materials of the Congress]. Saint-Petersburg; 2002. P. 549–50]

9. Захарова НС, Савченко НС, Лалов ЮА, Неговора ЕН. Методы коррекции энцефалопатии у больных с церебральными глиомами в отдаленном периоде хирургического лечения. Неврологический вестник. 2008;XL(2):86–91. [Zakharova NS, Savchenko NS, Lalov YuA, Negovora EN. Methods of correction of encephalopathy in patients with cerebral gliomas in the remote period of surgical treatment. Nevrologicheskii vestnik. 2008;XL(2):86–91. (In Russ.)].

10. Берснев ВП, Шустин ВА, Скоромец ТА, Степанов ТС. Хирургическое лечение эпилепсии. В кн.: Эпилепсия. Санкт-Петербург: НИПНИ им. В.М. Бехтерева; 2010. C. 797. [Bersnev VP, Shustin VA, Skoromets TA, Stepanov TS. Surgical treatment of epilepsy. In: Epilepsiya [Epilepsy]. Saint-Petersburg: NIPNI im. V.M. Bekhtereva; 2010. P. 797.]

11. Barkovich AJ, Kuzniecky RI, Jacson GD, et al. A developmental and genetic classification for malformation of cortical development. Neurology. 2005 Dec 27;65(12):1873–87. Epub 2005 Sep 28.

12. Щекутьев ГА, Гриндель ОМ. Нейрофизиологические исследования в клинике. Москва: Антидор; 2001. [Shchekut'ev GA, Grindel' OM. Neirofiziologicheskie issledovaniya v klinike [Neurophysiological studies in the clinic]. Moscow: Antidor; 2001.]

13. Карлов ВА. Эпилепсия у детей и взрослых женщин и мужчин. Москва: Медицина; 2010. [Karlov VA. Epilepsiya u detei i vzroslykh zhenshchin i muzhchin [Epilepsy in children and adult women and men]. Moscow: Medicine; 2010.]

14. Архипова НА. Соотношение суммарной ЭЭГ и нейронной активности коры в зоне очаговой патологии головного мозга. Журнал неврологии и психиатрии им. С.С. Корсакова. 2001;101(5):44–5. [Arkhipova NA. The ratio of the total EEG and neuronal activity of the cortex in the focal area of brain pathology. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2001;101(5):44–5. (In Russ.)].

15. Благосклонова НК, Новикова ЛА. Детская клиническая электроэнцефалография. Москва: Медицина; 1994. [Blagosklonova NK, Novikova LA. Detskaya klinicheskaya elektroentsefalografiya [Clinical electroencephalography in children]. Moscow: Medicine; 1994.]

16. Благосклонова НК. Клиническая электроэнцефалография. В кн.: Эпилептология детского возраста: Руководство для врачей. Под ред. А.С. Петрухина. Москва: Медицина; 2000. С. 309–406. [Blagosklonova NK. Clinical electroencephalography. In: Epileptologiya detskogo vozrasta: Rukovodstvo dlya vrachei [Epileptology in children: a Guide for physicians]. Petrukhin AS, editor. Moscow: Medicine; 2000. P. 309–406.]

17. Коршунов АГ, Щекутьев ГА, Коновалов АН и др. Опыт хирургического лечения больных с очаговыми формами височной эпилепсии. Журнал «Вопросы нейрохирургии» им. Н. Н. Бурденко, 2001;(4):10–3. [Korshunov AG, Shchekut'ev GA, Konovalov AN, et al. Experience of surgical treatment of patients with focal forms of temporal lobe epilepsy. Zhurnal «Voprosy neirokhirurgii» im. N.N. Burdenko. 2001;(4):10–3. (In Russ.)].

18. Шершевер АС. Диагностика и лечение прогредиентных форм эпилепсии. СанктПетербург: Десятка; 2008. С. 264. [Shershever AS. Diagnostika i lechenie progredientnykh form epilepsii [Diagnosis and treatment having a progressive form of epilepsy]. Saint-Petersburg: Desyatka; 2008. P. 264]


For citation:


Kalmykova G.V., Neretina A.F., Chefranova Z.Y. Specific features of epilepsy in children with brain tumors. Neurology, Neuropsychiatry, Psychosomatics. 2015;7(1S):54-59. (In Russ.) https://doi.org/10.14412/2074-2711-2015-1S-54-59

Views: 425


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)