NCMP-25. TUMOR-RELATED EPILEPSY IN PATIENTS WITH BRAIN TUMORS (PBT): AN ACADEMIC INSTITUTION EXPERIENCE

Abstract

Abstract BACKGROUND Brain tumors are the second most common cause of intractable focal epilepsy. Seizures can be the presenting symptom of PBT or develop later in the disease course, impacting morbidity and quality of life. Despite the high prevalence of PBT-related epilepsy, there is a scarcity of literature to help better identify its unique features and characterizations that can guide medical management and reach a standardized approach for it. We present a retrospective review of a cohort of PBT-related epilepsy cases at a single academic institution. METHODS Records of patients with PBT seen at Upstate Medical University between 2012 and 2022 were reviewed. Inclusion criteria were: 18 years of age and older at the time of diagnosis and having at least one seizure that thought to be related to a PBT. Patients with history of previous epilepsy or psychogenic non-epileptic seizures were excluded. RESULTS Of the 1103 reviewed records, 293 patients (26.56%) met the inclusion criteria. Mean age at tumor diagnosis was 57.7 years +/- 16.6, and mean follow-up after tumor diagnosis was 17.9 months. Seizures were the initial presentation of the brain tumor in 166 (56.66%) patients. The most common tumor was grade 4 glioma in 45% of patients. Anti-seizure medications were started in 92.1%, and the most commonly used medication was levetiracetam in 75%. Number of patients who underwent total resection of the tumor was 123 (42.4%). On the last follow-up visit, 56% of patients remained seizure-free. CONCLUSION Patients with PBT often develop epilepsy that, at times, can be intractable. More than half of our patients experienced a seizure as the presenting symptom. Even though more than 90% were started on anti-seizure medications, only 56% remained seizure-free on follow-ups. Since seizures dramatically affect the quality of life, managing seizures in this patient population warrants further studies.