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Seizures and Status Epilepticus in Critically Ill Cancer Patients

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Oncologic Critical Care

Abstract

Seizures and status epilepticus (SE) occur more commonly in oncologic patients than the general population. Similarly, seizures are more common in critically ill patients, and thus critically ill oncologic patients are at high risk for having seizures and SE. There are several etiologic factors contributing to SE in critically ill oncologic patients including complications of existing brain tumors, brain metastasis, chemotherapy, radiation therapy, and paraneoplastic limbic encephalitides in addition to the etiologies that trigger seizures in non-tumor patients such as central nervous system (CNS) infections, electrolyte derangements, strokes, and hemorrhages. There is not much literature to guide the evaluation and management of seizures and SE in this specific patient population. However, the principles of management of seizures and SE are identical to the management in non-cancer patients with the primary goal to achieve prompt seizure control. Long-term antiepileptic drug (AED) therapy should be tailored and taking into account the interactions with chemotherapeutic agents and adverse events specific to cancer patients. Non-pharmacologic treatment such as surgical resection and radiation therapy may also be indicated in long-term seizure control. The prognosis of patients with tumor-related SE is worse when compared to patients with non-tumor SE.

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Authors and Affiliations

  1. Stroke and Neurocritical Care, Department of Neurology, University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR, USA

    Vishank A. Shah

  2. Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jose I. Suarez

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  1. Vishank A. Shah
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  2. Jose I. Suarez
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Correspondence to Jose I. Suarez .

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Editors and Affiliations

  1. Department of Critical Care and Respiratory Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Joseph L. Nates

  2. Division of Anesthesiology, Critical Care and Pain Medicine, Department of Critical Care and Respiratory Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Kristen J. Price

Section Editor information

  1. Critical Care Department, Universidad del Rosario Hospital Universitario Fundacion Santa Fe de, Bogota, Colombia, Colombia

    Yenny Cardenas

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Shah, V.A., Suarez, J.I. (2020). Seizures and Status Epilepticus in Critically Ill Cancer Patients. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74588-6_34

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  • DOI: https://doi.org/10.1007/978-3-319-74588-6_34

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