ArticleJournal of neuro-oncology2025
Seizure characteristics in epilepsy patients with a primary brain tumor.
Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeEpilepsy is among the most prevalent neurological disorders, with one in 10 people experiencing a seizure in their lifetime. In adults, brain tumors are a common cause. While tumor-control outcomes are well studied, less is known about seizure control in this population.
methodsWe retrospectively reviewed the Clalit Dan–Petah Tikva County database (2000–2019), covering 1.55 million patients. Adults with primary brain tumors and epilepsy were identified by ICD-10 codes. Seizure control and management were assessed through anti-seizure medication (ASM) prescriptions, follow-up care, hospitalizations, and evaluation by specialized epilepsy clinics.
resultsAmong 1,557,764 individuals, 17,225 (1.1%) adults were diagnosed with a brain tumor, of whom 14.7% (n = 2,532) had secondary epilepsy. Glioma patients had more than double the epilepsy rate (29.2%, n = 878) compared to meningioma (13.1%, n = 1,417). Most epilepsy cases were associated with benign tumors (65.6%, n = 1,661). Overall, 9.7% (n = 1,672) were classified as high-risk for drug-resistant epilepsy (DRE), yet only 0.5% (n = 89) had a formal diagnosis. Of these, just 12 (0.7%) received follow-up at a specialized epilepsy clinic; the remainder were managed by community neurologists, oncologists, neurosurgeons, or primary care physicians. None of the patients with intractable epilepsy underwent evaluation for epilepsy surgery.
conclusionDespite adequate tumor control, many patients with tumor-related epilepsy continue to experience seizures after resection and oncological treatment, due to suboptimal management or intractability. Under-recognition of DRE and low referral rates to specialized epilepsy centers highlight a significant treatment gap. Improved referral pathways and comprehensive evaluations are needed to optimize seizure outcomes in this population.
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