Neurology Unit, OCB Hospital, AOU Modena, Italy.
Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy.
Epilepsy Behav. 2019 Dec;101(Pt B):106370. doi: 10.1016/j.yebeh.2019.06.014. Epub 2019 Jul 10.
Between 3 and 12% of all adult status epilepticus (SE) are caused by a brain tumor. Gliomas, and in particular, high-grade gliomas (HGGs), are at high risk of SE development. In this study, we aimed to describe the clinical characteristic and outcomes of tumor-associated SE (TASE) in a population of adult patients with glioma prospectively collected between 2013 and 2019. In the aforementioned period, we observed 26 TASE (median age: 68 years). Overall, 22 patients (85%) presented a HGG (one anaplastic astrocytoma and 21 a glioblastoma) while 4 had a LGG (two diffuse astrocytoma and two ganglioglioma). All the lesions were supratentorial, and the temporal lobe was the most frequently involved (20 patients). Fourteen patients (54%) had the SE episode as the first manifestation of the tumor; in the remaining 12 (all patients with a HGG), the development of SE heralded tumor progression or reappearance. When TASE outcomes were compared with the ones observed in the general population of SE (SEGP), the response to treatment was not different between the two populations (refractory SE (RSE)/super-refractory SE (SRSE) 12% versus 13%, p = 0.75). In the short-term, group with TASE had a significantly lower global disability (modified Rankin scale (mRS) < 3 at discharge: 60% versus 32%, p < 0.001; at 30 days follow-up: 62% versus 30%, p < 0.001) and mortality (30 days mortality: 4% versus 27%, p = 0.008). Six months and 1 year mortality did not show any difference between the two groups (6 months: 46% and 45%, respectively, p = 0.9; 1 year: 68% and 52%, respectively, p = 0.22). The appearance of TASE often heralds tumor grow and progression. Even in this context, it appears to be as treatment-responsive as SEGP and the short-term disability and mortality related to SE episode are lower than those observed in the SEGP. Proceedings of the 7th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures.
成人部分性癫痫持续状态（SE）中有 3%-12%由脑肿瘤引起。胶质瘤，特别是高级别胶质瘤（HGG），有发生 SE 的高风险。在这项研究中，我们旨在描述 2013 年至 2019 年期间前瞻性收集的成人胶质瘤患者中肿瘤相关性 SE（TASE）的临床特征和结局。在此期间，我们观察到 26 例 TASE（中位年龄：68 岁）。总体而言，22 例患者（85%）表现为 HGG（1 例间变性星形细胞瘤和 21 例胶质母细胞瘤），4 例为 LGG（2 例弥漫性星形细胞瘤和 2 例神经节细胞瘤）。所有病变均位于幕上，颞叶最常受累（20 例）。14 例患者（54%）以 SE 发作为肿瘤的首发表现；在其余 12 例（均为 HGG 患者）中，SE 的发生预示着肿瘤的进展或复发。当比较 TASE 结局与一般 SE 人群（SEGP）的结局时，两组的治疗反应无差异（难治性 SE（RSE）/超难治性 SE（SRSE）12%与 13%，p=0.75）。在短期，TASE 组的总体残疾程度显著较低（出院时改良 Rankin 量表（mRS）<3：60%比 32%，p<0.001；30 天随访时：62%比 30%，p<0.001）和死亡率（30 天死亡率：4%比 27%，p=0.008）。两组之间 6 个月和 1 年死亡率无差异（6 个月：分别为 46%和 45%，p=0.9；1 年：分别为 68%和 52%，p=0.22）。TASE 的出现常预示着肿瘤的生长和进展。即使在这种情况下，它似乎与 SEGP 一样具有治疗反应性，并且与 SE 发作相关的短期残疾和死亡率低于 SEGP 观察到的水平。第七届伦敦-因斯布鲁克癫痫持续状态和急性发作学术研讨会论文集。
