• Jerzy Hildebrand, Cristel Lecaille, Joëlle Perennes, and Jean-Yves Delattre.
• Fédération de Neurologie Mazarin, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. hildebrand@skynet.be
• Neurology. 2005 Jul 26; 65 (2): 212-5.

ObjectiveTo determine the presentation, incidence, and severity of seizures in follow-up of patients treated for primary brain tumors.MethodsA total of 234 consecutive patients attending an outpatient clinic for chemotherapy of a supratentorial brain tumor were examined.ResultsSeizures occurred in 183 patients. All patients with epilepsy were on antiepileptic drugs (AEDs). Compared with patients without epilepsy, patients with epilepsy had a higher proportion of low-grade gliomas (p < 0.001) and cortical tumor location (p < 0.001). In 158 (86.4%) patients, seizures were an early manifestation of the disease, and epilepsy developed in only 25 (13.6%) individuals in the course of the malignant disease. Generalization occurred in 50% of early seizures, but in only 19.1% of patients with seizures persisting after the initiation of AEDs and specific antitumor therapies. The reduction in seizure generalization was significant (p = 0.001). Despite AED and various antitumor treatments, one-half of the patients had a seizure within 1 month and two-thirds within 3 months before the last evaluation.ConclusionsMost tumor-related seizures first appear early in the course of disease, usually as a presenting manifestation. Antiepileptic drugs combined with specific antitumor treatments significantly reduce the rate of seizure generalization. However, most patients continue to have focal epilepsy during follow-up.

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