Cancer-related seizure responds to treatment

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - A severe seizure that can be life-threatening called "status epilepticus" that can occur secondary to cancer or its treatment is responsive to anti-seizure treatment and does not adversely impact survival, new research shows.

"Cancer-related status epilepticus accounts for about 10 percent of all cases of status epilepticus, but it has not been well studied," senior author Dr. David Schiff told Reuters Health. "The only case series I can think of have had fewer than 10 patients."

"Our sense when we started the study was that people thought the outcome of (cancer-related status epilepticus) was terrible," noted Schiff, a neurologist at the University of Virginia in Charlottesville.

"To our surprise, the status epilepticus was essentially always controllable" and seemed to have little impact on survival.

Schiff's study, which is reported in the Archives of Neurology for December, involved 35 patients who were seen at the University of Virginia between 1995 and 2002 for status epilepticus related to cancer or its treatment.

Status epilepticus, which typically occurred at tumor presentation or during disease progression, was controlled in all patients, the report indicates. This control was achieved using medications and dosages that would typically be employed in status epilepticus patients without cancer. The 30-day mortality rate was 23 percent.

"One of the messages from our study is that ... the status epilepticus itself is not a reason not to be aggressive with treatment," Schiff emphasized. "It is a manageable complication."

SOURCE: Archives of Neurology, December 2006.