24 de enero de 2012

Seizures and epilepsy in oncological practice: causes, course, mechanisms and treatment


J Neurol Neurosurg Psychiatry2007;78:342-349 doi:10.1136/jnnp.2006.106211

Review
Seizures and epilepsy in oncological practice: causes, course, mechanisms and treatment

Gagandeep Singh1, Jeremy H Rees2, Josemir W Sander2

1Department of Neurology, Dayanand Medical College, Ludhiana, India
2UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
Correspondence to: Professor Ley Sander Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; lsander@ion.ucl.ac.uk

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.