Today's improved tumor and epilepsy treatment possibilities have led to increased numbers of long-term care patients with symptomatic epilepsies caused by tumors. Pathophysiology, epidemiology, advancements in diagnosis, drug as well as surgical treatments are discussed with special emphasis being placed on seizure control, side effects, and quality of life. Because long-term care - often 10 to 20 years - is necessary, optimal individual treatment strategies have to be selected. New electrophysiological techniques, e.g., magnetic resonance imaging (MRI) and magnetic encephalography (MEG), as well as the interaction of anticonvulsive and chemo-therapeutic drugs should be taken into account. © Springer 2009.