Seizures and epilepsy in oncological practice: causes, course, mechanisms and treatment
Posted: Thu Oct 10, 2019 6:27 pm
Abstract
There are few data available on the causes and mechanistic basis, outcome and treatment of seizures and epilepsy in people with systemic cancer. Seizures and epilepsy in people with cancers other than primary brain tumours are reviewed here. Articles published in English, which discussed the neurological manifestations and complications of cancer and its treatment, were searched and information on the frequency, aetiology, and course of seizures and epilepsy was extracted. The frequency, aetiology and outcome of seizure disorders in patients with cancer differ from those in the general population. Intracranial metastasis, cancer drugs and metabolic disturbances are the most common causes. Infections, cerebrovascular complications of systemic cancer and paraneoplastic disorders are among the rarer causes of seizures in patients with neoplasms. Several drugs used in the treatment of cancer, or complications arising from their use, can trigger seizures through varied mechanisms. Most drug‐induced seizures are provoked and do not require long‐term treatment with antiepileptic drugs.
Epilepsy and seizures are among the most common neurological conditions affecting all ages. The overall incidence of epilepsy in developed countries is about 50/100 000 persons/year, and the cumulative lifetime incidence of seizures is over 10%.1,2 Likewise, cancer, another common medical condition, affects one in three people overall. In all, over 270 000 new cases of cancer were registered in the UK in 2000. Cancer is the cause of 26% of the deaths in the UK, and outnumbers heart disease as a cause of death.3 Seizures and epilepsy may therefore occur, coincidentally or otherwise, in some people with cancer, and the cancer may influence the incidence, treatment and prognosis of seizures and epilepsy.
We recently reviewed the comorbidity of cancer in people with epilepsy.4 Here we discuss the causes, outcome and treatment of seizures and epilepsy in people with neoplasms. This review focuses on the occurrence of seizures and epilepsy in people with systemic cancer, and excludes brain tumours as these have been discussed elsewhere.5,6 Mechanistic considerations involving cancer drug‐induced seizures are discussed in some detail, as these have not received much attention so far. Neurologists should be aware of the unique set of causes of seizures in people with cancer, as well as their outcome and treatment, especially as the occurrence of seizures in a patient with cancer often prompts neurological consultation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077803/
There are few data available on the causes and mechanistic basis, outcome and treatment of seizures and epilepsy in people with systemic cancer. Seizures and epilepsy in people with cancers other than primary brain tumours are reviewed here. Articles published in English, which discussed the neurological manifestations and complications of cancer and its treatment, were searched and information on the frequency, aetiology, and course of seizures and epilepsy was extracted. The frequency, aetiology and outcome of seizure disorders in patients with cancer differ from those in the general population. Intracranial metastasis, cancer drugs and metabolic disturbances are the most common causes. Infections, cerebrovascular complications of systemic cancer and paraneoplastic disorders are among the rarer causes of seizures in patients with neoplasms. Several drugs used in the treatment of cancer, or complications arising from their use, can trigger seizures through varied mechanisms. Most drug‐induced seizures are provoked and do not require long‐term treatment with antiepileptic drugs.
Epilepsy and seizures are among the most common neurological conditions affecting all ages. The overall incidence of epilepsy in developed countries is about 50/100 000 persons/year, and the cumulative lifetime incidence of seizures is over 10%.1,2 Likewise, cancer, another common medical condition, affects one in three people overall. In all, over 270 000 new cases of cancer were registered in the UK in 2000. Cancer is the cause of 26% of the deaths in the UK, and outnumbers heart disease as a cause of death.3 Seizures and epilepsy may therefore occur, coincidentally or otherwise, in some people with cancer, and the cancer may influence the incidence, treatment and prognosis of seizures and epilepsy.
We recently reviewed the comorbidity of cancer in people with epilepsy.4 Here we discuss the causes, outcome and treatment of seizures and epilepsy in people with neoplasms. This review focuses on the occurrence of seizures and epilepsy in people with systemic cancer, and excludes brain tumours as these have been discussed elsewhere.5,6 Mechanistic considerations involving cancer drug‐induced seizures are discussed in some detail, as these have not received much attention so far. Neurologists should be aware of the unique set of causes of seizures in people with cancer, as well as their outcome and treatment, especially as the occurrence of seizures in a patient with cancer often prompts neurological consultation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077803/