Seizures as the clinical presenting symptom in children with brain tumors.

This study summarizes our clinical and surgical experience with pediatric brain tumors that were initially presented with seizures. The records of 367 consecutive children, treated for brain tumors between the years 1996 and 2007, were retrospectively analyzed, focusing on the clinical manifestations, diagnostic gap, and postoperative seizure follow-up that lasted at least 2 years. Seizures, mainly focal, were the clinical manifestation of brain tumor in 57 of 367 children. Normal neurologic examination and electroencephalography (EEG) were in 77.8% and 37.5%, respectively. Diagnostic gap correlated with low-grade and temporal lobe tumors. Postoperative follow-up revealed freedom of seizure in 77.6%. Favorable seizure outcome correlated with low preoperative seizures frequency, preoperative response to antiepileptic drugs, and hemispheric tumor location. We conclude that response to antiepileptic drugs, generalized seizures, normal EEG, and normal neurologic examination should not exclude tumor etiology. Moreover, broader indications for imaging should be employed while evaluating a child with a seizure.