NCMP-25. SEIZURE INCIDENCE AND CONTRIBUTING FACTORS IN PATIENTS WITH LEPTOMENINGEAL DISEASE

Abstract

Seizures are a well-known complication of CNS malignancy, however there is little in the literature regarding leptomeningeal disease (LMD) and seizures. The incidence of seizures is unknown in this specific cohort as is the use or potential benefit of preventative anti-seizure medications (AEDs). Additionally, factors that might predispose LMD patients to seize or affect their survival are largely unexplored. Retrospective review of 79 patients with a diagnosis of LMD treated at a single institution from August 2012 to August 2017. Associations between categorical variables were tested using Fisher’s Exact tests. Differences in survival between groups were plotted with Kaplan Meier curves and tested using log-rank tests. All analyses were performed using SAS software. Seizure incidence in those with and without brain metastases was 22%. Of those who seized, 65% were admitted for this at least once while only one patient required intubation. Primary malignancy, type or route of chemotherapy administration, form of radiation therapy (craniospinal, focal, or whole brain), and number of brain metastases did not influence seizure development. Only 8% of patients who never had seizures were on a prophylactic AED. In patients who had brain metastasis, there was no significant difference in incidence of seizure before vs after LMD diagnosis suggesting that LMD does not significantly increase the risk of seizure compared to brain metastasis alone. There was additionally no significant difference in survival time between patients who did or did not seize. Median survival time of patients after LMD diagnosis was 4 months. The incidence of seizure in LMD patients is 22%. There were no statistically significant predisposing factors to seizure development. Additionally, the development of seizures does not affect survival in patients with LMD.