Clinical characteristics, EEG findings and implications of status epilepticus in patients with brain metastases

Published:October 16, 2019DOI:https://doi.org/10.1016/j.jns.2019.116538

      Highlights

      • Seizures are common in patients with metastases to the brain (MB).
      • Status epilepticus (SE) may occur in MB patients without a history of seizures.
      • SE in MB was most commonly in the context of progression or hemorrhage.
      • In all patients with MB, SE resolved with treatment.
      • SE in patients with MB was associated with a poor short-term prognosis.

      Abstract

      Purpose

      To evaluate the clinical implications of status epilepticus in patients with metastases to the brain as well as associated demographic, clinical, EEG and radiographic features.

      Methods

      Retrospective chart review of 19 patients with metastases to the brain who subsequently developed status epilepticus.

      Results

      Of the patients who developed status epilepticus only 36.8% had a prior history of seizures since diagnosis of brain metastases. Status epilepticus most commonly occurred in the setting of a new structural injury to the brain such as new metastases, increase in size of metastases or hemorrhage. 57.9% of patients had either refractory or super-refractory status epilepticus. Focal non-convulsive status epilepticus was the most common subtype occurring in 42.1% of patients. 31.6% of patients died within 30 days of the onset of status epilepticus.

      Conclusion

      Status epilepticus eventually resolved with treatment in all patients with brain metastases; however, it is associated with poor outcomes as nearly one-third was deceased within 30-days of onset. Nevertheless, no patients died during status epilepticus. Thus, status epilepticus may be indicative of an overall poor clinical status among patients with brain metastases.

      Keywords

      Abbreviations:

      MB (metastases to the brain), SE (Status epilepticus)
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