High end-of-life incidence of seizures and status epilepticus in patients with primary and secondary brain tumors,Journal of Neuro-Oncology

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High end-of-life incidence of seizures and status epilepticus in patients with primary and secondary brain tumors
Journal of Neuro-Oncology ( IF 3.2 ) Pub Date : 2022-11-03 , DOI: 10.1007/s11060-022-04133-1
Sophie von Brauchitsch _{1,

2} , Adam Strzelczyk _{1,

2} , Felix Rosenow _{1,

2} , Elisabeth Neuhaus _{1,

2,

3} , Daniel Dubinski ₄ , Joachim P Steinbach _{5,

6,

7} , Martin Voss _{5,

6,

7}

Affiliation

Purpose

Seizures pose a significant burden in patients with primary and secondary brain tumors during the end-of-life period. A wide range of 6 to 56% of clinically observed epileptic seizures at the end of life has been reported. We aimed to analyse the incidence of epileptic seizures at the end of life in brain tumor patients more accurately using not only clinical but also electrophysiological findings.

Methods

This retrospective, single center study included brain tumor patients who died during the stay on the ward or within 7 days after discharge between 01/2015 and 08/2020. Clinical observation of seizures derived from the original medical records and EEG findings (within 45 days prior to death) were analyzed to determine the incidence of seizures in that period.

Results

Of the 68 eligible patients, 50 patients (73.5%) suffered from seizures within 45 days prior to death, of which n = 24 had a status epilepticus. The diagnosis of seizures/ status epilepticus was determined either by the presentation of clinical signs in 45 patients and if not, by the detection of a (possible) non-convulsive status epilepticus in the EEG of five patients.

Conclusion

In the presence of neurologically trained staff and with the frequent use of routine EEG, we were able to identify seizures and to distinguish status epilepticus from encephalopathy/ hypoactive delirium. We detected a higher incidence of seizures and status epilepticus at the end of life in neurooncological patients than previously reported.

中文翻译：

原发性和继发性脑肿瘤患者癫痫发作和癫痫持续状态的临终发生率高

目的

在临终期间，癫痫发作对原发性和继发性脑肿瘤患者造成重大负担。据报道，临床观察到的临终癫痫发作占 6% 至 56%。我们的目的是不仅使用临床结果，还使用电生理学结果，更准确地分析脑肿瘤患者生命末期癫痫发作的发生率。

方法

这项回顾性单中心研究纳入了在 01/2015 和 08/2020 之间住院期间或出院后 7 天内死亡的脑肿瘤患者。对来自原始医疗记录和脑电图结果（死亡前 45 天内）的癫痫发作的临床观察进行了分析，以确定该时期癫痫发作的发生率。

结果

在 68 名符合条件的患者中，50 名 (73.5%) 患者在死亡前 45 天内发生过癫痫发作，其中 n = 24 名患者处于癫痫持续状态。癫痫发作/癫痫持续状态的诊断是通过 45 名患者的临床体征表现来确定的，如果没有，则通过在 5 名患者的 EEG 中检测到（可能的）非惊厥性癫痫持续状态来确定。