[Epileptic seizures as a manifestation of brain tumors: clinical and electroencephalographic correlations].

Epilepsy may be the earliest and the sole clinical manifestation of brain tumours. Different studies present epileptic seizures as the first symptom of a brain tumours in adults in approximately 30-40% of cases and in children from 1-10%. In order to evaluate the incidence of epileptic seizures in children versus adults with brain tumors, we investigated the group of 113 children and 578 adults who were hospitalized at the Departments of Neurology and Developmental Neurology between 1990-1999. Clinical presentation, imaging findings, EEG and pathology reports were collected by chart review and entered into computerized database. Of 113 children, epileptic seizures as a first symptom occurred in 14 children and in 211 adults. Histopathological origin and localization of tumours changed according to the age of patients. In all children's seizures were caused by supratentorial tumours originated from neuroepithelial tissue and mainly astrocytomas. In adult patients seizures were observed also mainly in supratentorial tumours (5 cases infratentorial) which were of metasthatic origin (60%) others were glioblastomas multiforme and sporadically meningiomas. The types of seizures in both groups differ significantly. Children had mainly secondary generalized seizures, while adults simple and complex partial seizures. Electroencephalographical findings showed paroxysmal activity always associated with supratentorial brain tumours with seizures; however, we found also abnormal EEG patterns in patients with infratentorial tumours without seizures. Partial and secondary generalized seizures, especially when they are intractable, should be subjected to further investigation for exclusion of brain tumour not only in adults but also in children. Normal EEG argues against the likehood of supratentorial lesions.