Seizure characteristics and the use of anti-epileptic drugs in children and young people with brain tumours and epileptic seizures: Analysis of regional paediatric cancer service population.

Pilotto, Chiara and Liu, Jo-Fen and Walker, David A. and Whitehouse, William P. (2018) Seizure characteristics and the use of anti-epileptic drugs in children and young people with brain tumours and epileptic seizures: Analysis of regional paediatric cancer service population. Seizure, 58 . pp. 17-21. ISSN 1059-1311

[img]
Preview
PDF (Seizure characteristics and the use of anti-epileptic drugs in children) - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Available under Licence Creative Commons Attribution Non-commercial No Derivatives.
Download (263kB) | Preview

Abstract

Purpose: Epileptic seizures complicate the management of childhood brain tumours. There are no published standards for clinical practice concerning risk factors, treatment selection or strategies to withdraw treatment with antiepileptic drugs (AED).

Method: We undertook a case note review of 120 patients with newly diagnosed brain tumours, referred to a regional paediatric cancer service.

Results: Data was available on 117/120 (98%) children <18 years: median age at tumour presentation was 8.1 years (IQR 25°-75°: 3.6-12.7), median follow up was 33 months (IQR 25°-75°: 24-56), and 35/117 (29%) experienced seizures. A cortical tumour location was associated with the highest risk of seizures (OR: 7.1; CI 95% 2.9-17.3). At a median follow up of 24 months (IQR25°-75°: 15-48), 22/35 (63%) with seizures, had a single seizure episode, 15/35 (43%) were seizure free (SF) on AEDs, 13/35 (37%) were SF off AEDs, and 7/35 (20%) experienced continuing epileptic seizures. Overall 34/35 (97%) were treated with AEDs after a seizure, of whom 12/35 (35%) withdrew from AED medication, and although 4/35 (12%) had seizure relapse, all were after further acute events. The median duration of AED before withdrawal was 11 months (IQR25°-75° 5-14 months), and the median follow up after withdrawal was 15 months (IQR25°-75° 5-34 months).

Conclusions: Seizures affect about 1/3rd of children and young people presenting with and being treated for brain tumours particularly when the tumour is in the cerebral cortex. The low risk of recurrent seizures after AED treatment justifies consideration of early withdrawal of AED after seizure control.

Item Type: Article
Keywords: Brain tumour; Paediatric; Seizure; Anti-epileptic drug
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Child Health, Obstetrics and Gynaecology
Identification Number: https://doi.org/10.1016/j.seizure.2018.03.016
Depositing User: Shreeve, Claire
Date Deposited: 24 Apr 2018 11:00
Last Modified: 21 Mar 2019 04:30
URI: http://eprints.nottingham.ac.uk/id/eprint/51289

Actions (Archive Staff Only)

Edit View Edit View