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Brain tumor and epilepsy program

Brain tumor and epilepsy program

Jeffrey Politsky, MD, FRCP(C)

Program description:
This program was developed to help physicians caring for patients with brain tumors (neuro-oncologists, neuro-surgeons, epilepsy specialists) provide the optimal level of care and to ensure these patients maintain the highest possible quality of life during and after the treatment process. Roughly 30-40% of patients with brain tumors develop recurrent seizures (tumor-induced epilepsy). The physical signs of seizures may be obvious (twitching, sensory disturbance, speech and language problems) or very subtle (sub-clinical seizures). The development of seizures can complicate the approach to patient care and requires a team approach. In some situations anti-seizure medication may be sufficient to control seizures and the tumor may be watched over time if it is “benign.” In other cases, surgery may be needed to remove the tumor. Continuous EEG is recommended in each case to determine the presence or absence of seizure activity in light of the heightened risk of seizures. If surgery is needed, continuous EEG and/or intracranial EEG may be utilized to map the epileptic brain regions. In surgical cases, functional brain mapping is also required: this will include special tests called a Magnetoencephalogram (MEG) and cortical brain mapping.  Cortical brain mapping is typically done in the operating theater.  Both tests are designed to help the surgeon and epilepsy doctors know where critically important brain functions are located.

Research activities:
Prevalence of status epilepticus in brain tumors
Relationship of brain tumor type and location to development of seizures
Response of tumor-induced epilepsy to anti-seizure medication

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