Epilepsy and brain tumours

The real mechanism of epileptic seizures in patients with brain tumours is still not well known. Usually they originate from irritated cortical structures close to the lesion, not exactly from the tumour cells. The most common brain tumours diagnosed in patients with epilepsy are: dysembryoplastic neuroepithelial tumour (DNT), gangliocytoma, ganglioglioma (1%), astrocytoma pilocyticum (4%), oligodendroglioma, hypothalamic hamartoma. The pathogenesis of drug-resistant epileptic seizures is associated with disrupted neuronal migration, developing irregular axodendritic connections, causing changes in morphological and biochemical features of neighbouring neurons as well as disturbances in secretion of neurotransmitters and neuromodulators. Before starting pharmacological treatment of epilepsy the possible interactions with chemotherapeutic agents should be carefully considered. The first epileptic seizure should cause the decision to perform magnetic resonance imaging of the brain, not only to diagnose the cortical lesions, but also to evaluate in detail the temporal lobe structures.