Chronic Intractable Epilepsy as the Only Symptom of Primary Brain Tumor

Authors

  • Harold H. Morris,

    Corresponding author
    1. Departments of Neurology, Section of Epilepsy and Sleep Disorders, The Cleveland Clinic Foundation, Cleveland, Ohio
      Address correspondence and reprint requests to Dr. H. H. Morris III at Section of Epilepsy and Sleep Disorders, Department of Neurology, Desk M52, The Cleveland Clinic Foundation, One Clinic Center, Cleveland, OH 44195-5221, U.S.A.
    Search for more papers by this author
  • Melinda L. Estes,

    1. Departments of Anatomic Pathology, Section of Neuropathology, The Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author
  • Robin Gilmore,

    1. Department of Neurology, University of Florida, Gainesville, Florida, U.S.A.
    Search for more papers by this author
  • Paul C. Van Ness,

    1. Departments of Neurology, Section of Epilepsy and Sleep Disorders, The Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author
  • Gene H. Barnett,

    1. Departments of Neurosurgery, Section of Stereotaxic Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author
  • John Turnbull

    1. Departments of Neurology, Section of Neurological Computing, The Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author

  • Presented in part at the annual meeting of The American Epilepsy Society in Philadelphia, December 10, 1991 and published in abstract form in Epilepsia 1991;32(suppl 1):64.

Address correspondence and reprint requests to Dr. H. H. Morris III at Section of Epilepsy and Sleep Disorders, Department of Neurology, Desk M52, The Cleveland Clinic Foundation, One Clinic Center, Cleveland, OH 44195-5221, U.S.A.

Summary:

We identified 39 patients with chronic epilepsy (seizures ≥2 years) proven to have primary brain tumors. These cases represent ∼12% of the surgery cases for epilepsy in the same period. Mean age of seizure onset was 13.2 years: mean duration before operation was 10.5 years. Thirty-eight of 39 had normal neurologic examination. Twenty-six tumors were temporal, 7 were frontal, 4 were parietal, and 2 were occipital. Nine of 26 (34.6%) of the temporal group had contralateral interictal EEG spikes. Pathology was 15 ganglioglioma, 13 low-grade astrocytoma, 4 oligodendroglioma, 2 low-grade mixed glioma, 1 pleomorphic xanthoastrocytoma, 2 dysembryoplastic neuroepithelial tumor, and 1 ependymoma. Postoperative seizure frequency (minimum follow-up 6 months) ranged from 15 to 16 seizure-free or auras only in patients with temporal tumors and total gross tumor removal (mean follow-up 28 months) to 0 of 6 seizure-free in patients with extratemporal tumors who underwent subtotal resections or biopsy.

Ancillary