title: Risk of seizure and its clinical implication in the patients with cerebral metastasis from lung cancer.
abstract: BACKGROUND
  The prevalence, risk factors, and clinical implication of seizure development were investigated in patients with metastatic brain tumors.
  
  
  METHODS
  Medical records and radiological findings were analyzed retrospectively in 258 patients with brain metastasis from lung cancer who underwent Gamma Knife radiosurgery (GKS) between January 2008 and December 2009.
  
  
  RESULTS
  During the follow-up period 32 patients (12.4 %) experienced seizure episodes. Coexistence of leptomeningeal seeding was a significant risk factor related to development of seizure (p < 0.001). Prophylactic use of anticonvulsants was not correlated with reduction of seizure incidence (p = 0.818). Continued use of anticonvulsants was necessary in nine of the 258 patients (3.5 %) because of recurrent seizures. Imaging studies performed immediately after seizure attacks in the patients with known metastatic brain lesions revealed tumor progression or complications related to treatment in 35 of 42 episodes of seizure (77.8 %).
  
  
  CONCLUSIONS
  Patients with metastatic lesions have a substantial risk of developing seizure. Seizure in known metastatic brain tumor patients are usually related to disease progression or complications of treatment. Follow-up imaging should be considered for each seizure episode and adequate multimodal treatment needs to be added to antiepileptic medication.
authors: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Min Ho
authors: MH
authors: Lee
authors: Doo-Sik
authors: DS
authors: Kong
authors: Ho Jun
authors: HJ
authors: Seol
authors: Do-Hyun
authors: DH
authors: Nam
authors: Jung-Il
authors: JI
authors: Lee
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D016634:Radiosurgery / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012640:Seizures / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery
chemical_list: D000927:Anticonvulsants