Children with Tumor-Related Epilepsy : A Surgical Dilemma

Children with drug resistant focal epilepsy due to both low grade as well as high grade neuronal and glioneuronal tumors can be treated surgically. However the neurosurgical approach is challenging, especially the decision on extent of resection. The latter should be tailored to the individual patient based on the clinical presentation, the appearance and location of the lesion, the results of phase I and II epilepsy investigation and epidemiological data. Familiarity with the clinical presentation and seizure semiology as well as the epidemiology of brain tumors in children, including age, localization and neuroimaging features, is pivotal for deciding on the appropriate surgical approach. In this communication we aim to give an overview on the epidemiology of pediatric brain tumors associated with epilepsy and their clinical features. We discuss the surgical dilemma on the extent of resection in order to achieve favorable seizure control and oncological outcome, while minimizing morbidity and optimizing cognitive development.