Paroxismal disorders in children with cerebellar tumors

Abstract

Background: The cerebellum is involved in the pathogenesis of epileptic and non-epileptic paroxysmal disorders. Cerebellar lesions or the removal of cerebellar structures leads to a decreased effectiveness of antiparoxysmal treatment. The paroxysmal activity in patients with cerebellar tumors is currently not fully studied. The aim of the study was to find out the frequency of clinical paroxysmal disorders, the duration and intensity of paroxysmal activity of the brain in children with cerebellar tumors. Material and methods: There were enrolled 36 pediatric patients with brain tumors: left hemisphere (LH) – 15; vermis (VE) – 11; right hemisphere (RH) – 10. The paroxysmal clinical manifestations, duration of the paroxysmal activity (Paroxysmal Index, Ip, %) and the intensity of the paroxysmal activity (Io, %) were studied via 3D computerized EEG method and brain localization system technology (BrainLoc – 4). Results: The observed frequency of non-epileptic paroxysmal disorders were: orthostatic syncope (OS) – 11.1%; nocturnal phobias (NP) – 22.2%; hypnic jerks (HJ) – 44.4%; sleep talking (ST) – 33.3%; night terrors (NT) – 22.2%; enuresis (EN) – 11.1%; bruxism (BR) – 22.2%. The following associations of paroxysmal disorders were observed: OS + EN (11.1%); NP + HJ + ST (22.2%), NT + HJ (11.1%), BR + HJ (11.1%). The following values of Ip/Io indices were observed: LH lesion – 8.9 ± 1.31%/72.4 ± 3.89%, RH lesion – 8.7 ± 1.39%/77.9 ± 4.92%, VE lesion – 2.29 ± 2.11%/52.5 ± 8.6%. Conclusions: In children with cerebellar tumors, non-epileptic paroxysmal disorders were observed in 11.1 – 44.4% of cases. In case of lesions affecting the cerebellar hemispheres, the duration and intensity of the paroxysmal activity is higher when compared to vermis lesions.