Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital/ Goethe University Frankfurt, Frankfurt am Main, Germany.
LOEWE Center for Personalized and Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany.
J Neurooncol. 2022 Nov;160(2):277-284. doi: 10.1007/s11060-022-04133-1. Epub 2022 Nov 3.
Seizures pose a significant burden in patients with primary and secondary brain tumors during the end-of-life period. A wide range of 6 to 56% of clinically observed epileptic seizures at the end of life has been reported. We aimed to analyse the incidence of epileptic seizures at the end of life in brain tumor patients more accurately using not only clinical but also electrophysiological findings.
This retrospective, single center study included brain tumor patients who died during the stay on the ward or within 7 days after discharge between 01/2015 and 08/2020. Clinical observation of seizures derived from the original medical records and EEG findings (within 45 days prior to death) were analyzed to determine the incidence of seizures in that period.
Of the 68 eligible patients, 50 patients (73.5%) suffered from seizures within 45 days prior to death, of which n = 24 had a status epilepticus. The diagnosis of seizures/ status epilepticus was determined either by the presentation of clinical signs in 45 patients and if not, by the detection of a (possible) non-convulsive status epilepticus in the EEG of five patients.
In the presence of neurologically trained staff and with the frequent use of routine EEG, we were able to identify seizures and to distinguish status epilepticus from encephalopathy/ hypoactive delirium. We detected a higher incidence of seizures and status epilepticus at the end of life in neurooncological patients than previously reported.
在生命终末期，原发性和继发性脑肿瘤患者常伴有癫痫发作，这给患者带来了沉重的负担。据报道，临床上观察到的终末期癫痫发作的发生率范围很广，为 6%至 56%。我们旨在通过结合临床和电生理结果，更准确地分析脑肿瘤患者生命终末期癫痫发作的发生率。
本回顾性单中心研究纳入了 2015 年 1 月至 2020 年 8 月期间在病房住院或出院后 7 天内死亡的脑肿瘤患者。我们分析了源自原始病历的癫痫发作临床观察结果和 EEG 结果（死亡前 45 天内），以确定该期间的癫痫发作发生率。
在 68 名符合条件的患者中，有 50 名患者（73.5%）在死亡前 45 天内发生了癫痫发作，其中 24 名患者出现了癫痫持续状态。45 名患者通过临床症状确定了癫痫/癫痫持续状态的诊断，如果没有，则通过对 5 名患者 EEG 中（可能）非惊厥性癫痫持续状态的检测确定了诊断。
在有神经科训练有素的工作人员的情况下，并且常规 EEG 的使用频繁，我们能够识别癫痫发作，并将癫痫持续状态与脑病/低反应性谵妄区分开来。我们在神经肿瘤患者中检测到的生命终末期癫痫发作和癫痫持续状态的发生率高于之前的报告。
