Pediatric Astrocytoma Causing Intractable Epilepsy

Intractable epilepsy can stem from numerous causes, including brain tumors. Here we describe an unusual presentation of a child with medically refractory epilepsy and developmental delay. She was determined to be an atypical case for epilepsy surgery due to the presence of multifocal lesions on MRI and poorly localizable ictal and interictal EEG features. A surgical resection was performed on the largest lesion and pathological analysis was consistent with astrocytoma. Post-resection she has had a significant reduction in her seizures, with an improvement in her development. Patients with refractory epilepsy should be evaluated for potential epilepsy surgery. It is important to identify these patients early to limit the potential morbidity and mortality and improve their quality of life.