Abstracts

Rationale: Epileptic seizures are frequently encountered in patients with brain tumors. This retrospective study was carried out to report one of the largest series from a single center of adult patients, and comprehensively analyze seizure occurrence with different types of brain tumors.   Methods: After obtaining IRB approval, the Henry Ford Corporate Data Store and EPIC (electronic medical record) were used to identify patients who had a diagnosis of brain tumor at Henry Ford health system.  Demographics, clinical data, and pharmacy information were collected and a death index check was performed on each patient. Results:  A total of 578 patients were noted to have a brain tumor diagnosis between January 1, 2006 and December 31, 2014.  Excluding 69 patients due to insufficient clinical information, 509 patients were included in the analysis. Of the 509 patients, 51% were male, 81% were Caucasian, 15% were African American and the mean age was 58.7 (range: 18 to 91).  At the time of data collection, 315 (62%) of the patients were deceased.  A total of 273 (53%) patients were diagnosed with glioblastoma, 122 (24%) with meningioma, 48 (9%) with anaplastic astrocytoma, 24 (5%) with astrocytoma, and 23 patients with oligodendrogliomas or other tumor types. Seizure as a presenting symptom was seen in 29% of the patients and 36% of the patients experienced a seizure after diagnosis. The association between tumor type (glioblastoma, anaplastic astrocytoma, astrocytoma, meningioma, oligodendrogliomas with other tumor types) and seizures, as a presenting symptom was not significant (p=0.67, chi-squared test).  However, the association between tumor type and seizures after diagnosis was significant (p=0.016, chi-squared test), with glioblastomas, anaplastic astrocytomas and astrocytomas having the higher rates (41%, 38% and 47%, respectively) and the meningiomas and oligodendrogliomas with other types having the lower rates (24% and 29%).  Surgical procedures were performed in 94% of the patients (35% subtotal resection, 41% gross total resection and 24% biopsy only).  Majority of the tumors were cortical (73%) (vs. subcortical (11%) and both (12%)).  The vast majority were treated with combined chemotherapy and radiation (71%), while 6% received chemotherapy only and 13% radiation only.  Thirty percent of the patients also received hospice care. The two most common anti-seizure medications prescribed immediately after tumor diagnosis were Levetiracetam (45%) and Phenytoin (32%), regardless of presence of seizure symptoms.  Conclusions: Our study shows that in adult patients with brain tumor, 29% experience seizure as a presenting symptom irrespective of the tumor type, and 36% experience seizure sometime after the diagnosis, more often with astrocytoma type of tumor. Further assessment of seizure outcomes are necessary to better help establish overall outcomes in patients with brain tumor. Funding: Henry Ford Internal Funding