Why Comprehensive Care Is Key

In almost half of patients with brain tumors, the tumor was discovered during imaging after they had a seizure for the first time. A seizure is a brief burst of abnormal electrical activity in the brain that leads to variable symptoms, such as twitching or whole body shaking. When someone has more than one unprovoked seizure, they are diagnosed with a brain condition known as epilepsy. When epilepsy is related to a brain tumor, seizures are caused by excessive firing of the neurons in and around the tumor.

“Patients may not be aware that seizures are a consequence of their brain tumor”, says Jessica W. Templer, MD, a neurologist specializing in epilepsy at Northwestern Medicine Comprehensive Epilepsy Center. “The seizures caused from brain tumors are complex and different for each patient depending on the type and location of the tumor.” 

Seizures can occur with any type of brain tumor, benign or malignant, but they are more common in low-grade, more benign tumors. 

Comprehensive Care for Tumors and Seizures

Patients battling a brain tumor and seizures require treatment for both. Often, the surgery to remove the tumor is the best opportunity to remove the seizure focus and stop the seizures. In others, seizures persist after surgery or develop later, and patients need ongoing treatment for their epilepsy. To provide this level of comprehensive care, Dr. Templer and her team collaborate with the Lou and Jean Malnati Brain Tumor Institute at Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

“Treatment depends on the type of tumor,” states Dr. Templer. Some patients may benefit from an electroencephalogram (EEG), which records the electrical activity in the brain and identifies abnormalities, allowing physicians to better understand the seizure focus and risk for seizure recurrence. Armed with this knowledge, specialists can come up with a treatment plan.

Medication can help to reduce or stop seizures, although patients who are already receiving brain tumor treatment might be battling lethargy and other negative side effects, and seizure medication need to be well chosen. Epilepsy surgery can be an option in some patients who cannot be controlled by medication.

"You can’t take a simplistic approach because of the complexity,” Dr. Templer continues. “We’re always visiting the quality of life at each visit, so they can continue to do what they want.”

How to Spot a Seizure

Each person experiences seizures differently, and seizures may last anywhere from seconds to minutes. During a seizure, you may notice the following:

• Aura, a sudden, brief, unusual sensation
• Uncontrolled jerking
• Brief time gaps or confusion
• Falls
• Bystanders may notice staring, unresponsiveness or stiffening and jerking followed by confusion

It is often the first bigger seizure which makes patients to have brain imaging including magnetic resonance imaging (MRI) or a computed tomography (CT). Many patients already had smaller events or auras which went unrecognized.

Most seizures stop by themselves within two to three minutes, although there can be a prolonged period of confusion afterwards. For seizures longer than five minutes, a call for an ambulance should be placed.

How to Manage Seizures

A number of lifestyle changes can reduce the chance of triggering a seizure. “The best thing you can do is make yourself a priority,” says Dr. Templer. She suggests getting the recommended amount of sleep, exercising frequently and avoiding alcohol.

Find out what to do — and what not to do — if someone near you has a seizure.