Brain Tumor and Seizures: Incidence, Pathophysiology, Diagnosis and Treatment

Seizures can arise as a complication of a number of disease states such as metabolic abnormalities, intoxication or withdrawal from drugs, acute trauma, infection; the list is exhaustive (Delanty, Vaughan et al. 1998). One of the most common causes of seizures is indeed the presence of a brain tumor. Seizures present a preventative, diagnostic and management challenge for a number of reasons in this situation. The drugs used for treatment may interfere with chemotherapy, may produce untoward cognitive or medical side effects, and may not even reach the intended target since the blood brain barrier may be pathologic in the abnormal environment of the tumor. The many genetic and pathological variations in tumor type may further impact therapies aimed at treating seizures in this setting. Further complicating this scenario is the post-operative management of these patients, which may occur in an ICU most complex environment. This chapter will review contemporary issues in pathophysiology, clinical presentation, complications, treatment, and outcomes of seizures associated with brain tumors.