Children with cancer are a population with specific risk factors for the development of seizures. They present distinct problems in assessment and management that sets them apart from the usual pediatric patients. We reviewed the information gathered on our pediatric neurooncology database regarding 47 children with systemic cancer complicated by seizures. Leukemia was the most frequent underlying cancer (47%). In children with hematologic cancers, toxic-metabolic disturbances were the most frequent cause of seizures, whereas in patients with solid cancers, metastases were the single most common etiology. Children undergoing bone marrow transplant were particularly susceptible to seizures (34%), but only a minority progressed to develop a chronic seizure disorder (19.1%). Neuroimaging studies provided useful etiologic information in 62%. The choice of the antiseizure medication should take into account the potential interaction with the chemotherapy or supportive drugs often administered to these patients.
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