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Status epilepticus management in patients with brain tumors. A cohort study

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Bibliographic Details
Title: Status epilepticus management in patients with brain tumors. A cohort study
Authors: Andria Tziakouri, Andreas F. Hottinger, Jan Novy, Andrea O. Rossetti
Source: Seizure, vol. 120, pp. 1-4
Publisher Information: Elsevier BV, 2024.
Publication Year: 2024
Subject Terms: Humans, Status Epilepticus/etiology, Status Epilepticus/drug therapy, Status Epilepticus/therapy, Male, Brain Neoplasms/complications, Brain Neoplasms/secondary, Brain Neoplasms/therapy, Female, Middle Aged, Retrospective Studies, Aged, Anticonvulsants/therapeutic use, Adult, Cohort Studies, Registries/statistics & numerical data, Glioma/complications, Glioma/therapy, ASM, Glioma, Metastasis, Outcome, Refractory, Treatment, Brain Neoplasms, 3. Good health, Status Epilepticus, Anticonvulsants, Registries
Description: Status epilepticus (SE) represents a neurological emergency with significant morbidity and mortality. SE in patients with primary brain tumors received only limited attention to date; detailed analysis of treatment flow is lacking, especially as compared to other SE causes. This study aims to describe the frequency and treatment flow of tumor-related SE and compare it to other SE etiologies.Retrospective cohort study based on an institutional SE registry (SERCH) comprising adult SE (excluding post-anoxic causes), treated between January 2013 and December 2022, comparing SE management, frequency of refractory SE, and clinical outcome, among four patients' groups stratified by SE etiology: Non-neoplastic, Gliomas, Brain metastases, Other brain tumors.We analyzed 961 episodes in 831 patients (Non-neoplastic: 649, Gliomas: 85, Metastases: 77, Other brain tumors: 20). Although tumor-patients presented more often with focal episodes and less consciousness impairment than non-neoplastic patients, administration of benzodiazepines as first-line treatment (>75% across all groups), and utilization of second-line ASM were similar across groups. Treatment adequacy was marginally higher in glioma patients compared to the non-neoplastic population (p: 0.049), while refractory SE was comparable in all groups (p: 0.269). No significant differences in clinical outcomes were observed (mortality: non-neoplastic (89/649, 13.7%), glioma (8/85, 9.4%), metastases (14/77, 18.2%), other tumors (5/20, 25.0%), p: 0.198; non-neoplastic vs. glioma, p: 0.271) CONCLUSION: Tumor-associated SE represents 1/5 of all SE episodes, and is managed similarly to other SE causes. Treatment responsiveness and short-term clinical outcomes also exhibit comparable results.
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 1059-1311
DOI: 10.1016/j.seizure.2024.06.005
Access URL: https://pubmed.ncbi.nlm.nih.gov/38875892
https://serval.unil.ch/notice/serval:BIB_93536ECC1573
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_93536ECC15737
https://serval.unil.ch/resource/serval:BIB_93536ECC1573.P001/REF.pdf
Rights: CC BY
Accession Number: edsair.doi.dedup.....5e7c32b1686f84ed281c9bbb2cbc8a9c
Database: OpenAIRE
Description
Abstract:Status epilepticus (SE) represents a neurological emergency with significant morbidity and mortality. SE in patients with primary brain tumors received only limited attention to date; detailed analysis of treatment flow is lacking, especially as compared to other SE causes. This study aims to describe the frequency and treatment flow of tumor-related SE and compare it to other SE etiologies.Retrospective cohort study based on an institutional SE registry (SERCH) comprising adult SE (excluding post-anoxic causes), treated between January 2013 and December 2022, comparing SE management, frequency of refractory SE, and clinical outcome, among four patients' groups stratified by SE etiology: Non-neoplastic, Gliomas, Brain metastases, Other brain tumors.We analyzed 961 episodes in 831 patients (Non-neoplastic: 649, Gliomas: 85, Metastases: 77, Other brain tumors: 20). Although tumor-patients presented more often with focal episodes and less consciousness impairment than non-neoplastic patients, administration of benzodiazepines as first-line treatment (>75% across all groups), and utilization of second-line ASM were similar across groups. Treatment adequacy was marginally higher in glioma patients compared to the non-neoplastic population (p: 0.049), while refractory SE was comparable in all groups (p: 0.269). No significant differences in clinical outcomes were observed (mortality: non-neoplastic (89/649, 13.7%), glioma (8/85, 9.4%), metastases (14/77, 18.2%), other tumors (5/20, 25.0%), p: 0.198; non-neoplastic vs. glioma, p: 0.271) CONCLUSION: Tumor-associated SE represents 1/5 of all SE episodes, and is managed similarly to other SE causes. Treatment responsiveness and short-term clinical outcomes also exhibit comparable results.
ISSN:10591311
DOI:10.1016/j.seizure.2024.06.005