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Neuropediatrics 2021; 52(06): 480-483
DOI: 10.1055/s-0041-1728653
Short Communication

Utility of Epilepsy Surgery in Survivors of Childhood Cancer

Ayat Siddiqui
1   The Aga Khan University, Karachi, Pakistan
,
Amy L. McGregor
2   Division of Pediatric Neurology, Le Bonheur Comprehensive Epilepsy Program, University of Tennessee, Memphis, Tennessee, United States
,
James W. Wheless
2   Division of Pediatric Neurology, Le Bonheur Comprehensive Epilepsy Program, University of Tennessee, Memphis, Tennessee, United States
,
Paul Klimo
3   Department of Neurosurgery, University of Tennessee, Memphis, Tennessee, United States
,
Frederick A. Boop
3   Department of Neurosurgery, University of Tennessee, Memphis, Tennessee, United States
,
Raja B. Khan 
4   Division of Neurology, St. Jude Children's Research Hospital, Memphis, Tennessee, United States
› Author Affiliations Funding This work was supported in part by the American Lebanese Syrian Associated Charities (ALSAC) and the National Cancer Institute grant (P30 CA021765) (St. Jude Cancer Center Support Grant). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Abstract

Resection of an epileptogenic focus improves seizure control in patients with drug-resistant epilepsy. There is little data available on usefulness of epilepsy surgery in childhood cancer survivors with drug-resistant epilepsy. To learn about seizure outcome after epilepsy surgery in childhood cancer survivors, we retrospectively reviewed charts of 42 children who were referred to an epilepsy center for surgical evaluation. Sixteen children (38%) were offered epilepsy surgery and 10 consented. Seizure outcome was classified based on International League Against Epilepsy outcome scale. All 10 children were having multiple seizures a month on therapeutic doses of three antiepilepsy drugs (AEDs). At a median follow-up of 5.6 years after epilepsy surgery, three children had class 1 outcome (no seizures), four had class 3 outcome (1–3 seizure days/year), and three had class 4 outcome (≥ 50% reduction in seizure frequency). One child was off AEDs, seven were on a single AED, and two were on three AEDs at their last follow-up. Epilepsy surgery had low morbidity and improved seizure control in childhood cancer survivors with drug-resistant epilepsy. Childhood cancer survivors with drug-resistant epilepsy should be referred to an epilepsy center for a higher level of care.

Keywords

refractory seizures - childhood cancer - epilepsy surgery - brain tumors


Publication History

Received: 12 August 2020

Accepted: 24 February 2021

Article published online:
14 April 2021

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