Introduction: Symptomatic seizures can have a significant impact on the quality of life. In tumor related seizures, the treatment is tailored to simultaneously eliminate the seizures and to obtain surgical resection of the tumor.

Material and methods: This is a single-center retrospective analysis. All the patients were treated in our institution from January 2022 to December 2022. Inclusion criteria for this study were presence of intracranial neoplasm on admission and presence of symptomatic epilepsy on admission. We analysed patient’s characteristics, tumor localisation, type of surgical resection, extent of resection, histological data, preand post-operative antiepileptic drugs usage and frequency of seizures before and after surgery.

Results: Out of 58 patients treated for intracranial tumor, 35 patients were included in our analysis. Male to female ratio close to 1:1. The mean age was 46.9 (18-75) years old. There were 51% of patients admitted to the hospital because of an onset seizure, and the rest 49% of patients had a previous history of epilepsy, in which refractory epilepsy accounted for 5.7% (2 cases). 18% of patients had epilepsy for more than 1 year before the surgery. The patohystological findings were consistent with high grade gliomas in 21 patients, low grade gliomas in 9 patients, cavernoma in 3 patients, metastasis in 2 patients. According to the extent of resection, 15% of the patients had suopramargical resection, 74% of the patients had gross total resection and 11% subtotal resection. Generalized seizures were the most prevalent seizure type (65%), followed by focal seizures (35%). At 6 and 12 months follow up after surgery, those who suffered from > 1 year of epilepsy history had a higher risk of seizures recurrence (p = 0.009 and p = 0.003 respectively). The patients with supramarginal and gross total resection had low postoperative seizure incidence. There was correlation between Ki67 proliferation index and seizure incidence in both low-grade and high-grade gliomas.

Conclusion: The surgical strategy and the greater extent of resection can lead to reduction of seizure occurrence. In the long-term follow up, a seizure is more challenging to control in frontotemporal tumors, low-grade gliomas, tumors that have increased Ki67 profileration index or tumor that cause major peritumoral edema