Seizures in Patients With Metastatic Brain Tumors: Prevalence, Clinical Characteristics, and Features on EEG
| Autor: | Jonah Fox, Alain Lekoubou, Adam Greenblatt, Adriana Olar, Shaun Ajinkya, David Cachia, Peter Houston, Ekrem Kutluay, Scott Lindhorst |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Physiology Electroencephalography Gastroenterology 050105 experimental psychology 03 medical and health sciences 0302 clinical medicine Text mining Seizures Physiology (medical) Internal medicine medicine Prevalence Humans 0501 psychology and cognitive sciences In patient Aged Retrospective Studies medicine.diagnostic_test business.industry Brain Neoplasms Melanoma 05 social sciences Cancer Retrospective cohort study Odds ratio Middle Aged medicine.disease Neurology Adenocarcinoma Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society. 38(2) |
| ISSN: | 1537-1603 |
| Popis: | Introduction Metastases to the brain (MB) occur in up to 30% of adults with cancer; of these, 15% to 35% may have seizures. We investigated clinical and pathologic associations with seizure and EEG findings in patients with MB, given the sparse literature in this area. Methods We performed a retrospective chart review of adults with pathologically confirmed MB treated at a large tertiary care center between April 8, 2006, and December 14, 2018. Primary outcomes were odds of "chart-documented seizure" (CDS) in the full sample and EEG-captured seizure or any epileptiform discharges among those monitored on EEG. Results We studied 187 patients with MB, of whom 55 (28.3%) were monitored on EEG. We found an overall CDS prevalence of 29.4% and an EEG-captured seizure of 18.9% among patients monitored on EEG. Of those monitored on EEG, 47.2% had epileptiform discharges. Adenocarcinoma pathology was associated with lower odds of CDS (odds ratio [OR] 0.50, 95% CI 0.26-0.96) and EEG-captured seizure (OR 0.09, 95% CI 0.01-0.87) versus other pathologies. When modeled separately, melanoma pathology was associated with CDS (OR 4.45, 95% CI 1.58-12.57) versus other pathologies. Hemorrhagic MB were associated with any epileptiform discharges (OR 5.50, 95% CI 1.65-18.37), regardless of pathology modeled. Increasing size of the largest dimension of the largest MB was associated with lower odds of CDS (OR 0.68, 95% CI 0.52-0.89 when adenocarcinoma modeled, OR 0.69, 95% CI 0.53-0.91 when melanoma modeled). Conclusions Seizures and epileptiform discharges are common in patients with MB. Tumor size and pathology were significantly associated with CDS. Larger studies are needed for further analysis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|