Epilepsy in the end-of-life phase in patients with high-grade gliomas

Abstract  

Epilepsy is common in patients with brain tumors. Patients presenting seizures as the first sign of a malignant glioma are at increased risk of recurrent seizures despite treatment with antiepileptic drugs. However, little is known about the incidence of epilepsy in the last stage of disease and in the end–of-life phase of brain tumor patients. We retrospectively analyzed the incidence of seizures in the last months of life in a series of patients affected by high-grade gliomas who were assisted at home during the whole course of the disease until death. A total of 157 patients were available for analysis. Of these patients, 58 (36.9 %) presented seizures in the last month before death. The risk of seizures in the end-of-life phase is higher in patients presenting previous history of epilepsy, particularly in patients with late-onset epilepsy. Out of the 58 patients presenting seizures in the last month of life, 86.2 % had previously had seizures and 13.8 % were seizure free. Most patients may encounter swallowing difficulties in taking anticonvulsants orally due to dysphagia and disturbances of consciousness, thus anticonvulsant treatment needs to be modified in advance. Loss of seizure control in the end-of-life phase may influence the quality of life of patients and their caregivers.

• Content Type Journal Article
• Category Clinical Study
• Pages 1-4
• DOI 10.1007/s11060-012-0993-2
• Authors
  • Andrea Pace, Palliative Home Care Unit for Brain Tumor Patients, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
  • Veronica Villani, Palliative Home Care Unit for Brain Tumor Patients, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
  • Cherubino Di Lorenzo, Palliative Home Care Unit for Brain Tumor Patients, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
  • Lara Guariglia, Palliative Home Care Unit for Brain Tumor Patients, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
  • Marta Maschio, Palliative Home Care Unit for Brain Tumor Patients, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
  • Alfredo Pompili, Palliative Home Care Unit for Brain Tumor Patients, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
  • Carmine Maria Carapella, Palliative Home Care Unit for Brain Tumor Patients, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy

• Journal Journal of Neuro-Oncology
• Online ISSN 1573-7373
• Print ISSN 0167-594X

http://www.springerlink.com/content/hm86725605866075/

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