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Seizure
Article . 2024 . Peer-reviewed
License: CC BY
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Serveur académique lausannois
Article . 2024
License: CC BY
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Status epilepticus management in patients with brain tumors. A cohort study

Authors: Andria Tziakouri; Andreas F. Hottinger; Jan Novy; Andrea O. Rossetti;

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

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.

Country
Switzerland
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Keywords

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, Male, Adult, Brain Neoplasms, Glioma, Middle Aged, Cohort Studies, Status Epilepticus, Humans, Female, Anticonvulsants, Registries, Retrospective Studies, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Top 10%
Average
Average
Green
hybrid
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