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Status epilepticus in patients with brain tumors and metastases: A multicenter cohort study of 208 patients and literature review.

Authors :
Rickel, Johanna K.
Zeeb, Daria
Knake, Susanne
Urban, Hans
Konczalla, Jürgen
Weber, Katharina J.
Zeiner, Pia S.
Pagenstecher, Axel
Hattingen, Elke
Kemmling, André
Fokas, Emmanouil
Adeberg, Sebastian
Wolff, Robert
Sebastian, Martin
Rusch, Tillmann
Ronellenfitsch, Michael W.
Menzler, Katja
Habermehl, Lena
Möller, Leona
Czabanka, Marcus
Source :
Neurological Research & Practice; 4/4/2024, Vol. 6 Issue 1, p1-14, 14p
Publication Year :
2024

Abstract

Objective: Brain tumors and metastases account for approximately 10% of all status epilepticus (SE) cases. This study described the clinical characteristics, treatment, and short- and long-term outcomes of this population. Methods: This retrospective, multi-center cohort study analyzed all brain tumor patients treated for SE at the university hospitals of Frankfurt and Marburg between 2011 and 2017. Results: The 208 patients (mean 61.5 ± 14.7 years of age; 51% male) presented with adult-type diffuse gliomas (55.8%), metastatic entities (25.5%), intracranial extradural tumors (14.4%), or other tumors (4.3%). The radiological criteria for tumor progression were evidenced in 128 (61.5%) patients, while 57 (27.4%) were newly diagnosed with tumor at admission and 113 (54.3%) had refractory SE. The mean hospital length of stay (LOS) was 14.8 days (median 12.0, range 1–57), 171 (82.2%) patients required intensive care (mean LOS 8.9 days, median 5, range 1–46), and 44 (21.2%) were administered mechanical ventilation. All patients exhibited significant functional status decline (modified Rankin Scale) post-SE at discharge (p < 0.001). Mortality at discharge was 17.3% (n = 36), with the greatest occurring in patients with metastatic disease (26.4%, p = 0.031) and those that met the radiological criteria for tumor progression (25%, p < 0.001). Long-term mortality at one year (65.9%) was highest in those diagnosed with adult-type diffuse gliomas (68.1%) and metastatic disease (79.2%). Refractory status epilepticus cases showed lower survival rates than non-refractory SE patients (log-rank p = 0.02) and those with signs of tumor progression (log-rank p = 0.001). Conclusions: SE occurrence contributed to a decline in functional status in all cases, regardless of tumor type, tumor progression status, and SE refractoriness, while long-term mortality was increased in those with malignant tumor entities, tumor progressions, and refractory SE. SE prevention may preserve functional status and improve survival in individuals with brain tumors. [ABSTRACT FROM AUTHOR]

Details

Language :
English
Volume :
6
Issue :
1
Database :
Complementary Index
Journal :
Neurological Research & Practice
Publication Type :
Academic Journal
Accession number :
176452226
Full Text :
https://doi.org/10.1186/s42466-024-00314-7