Abstracts

Rationale: Brain metastases are most common problem in neuro-oncology. Brain metastasis often presents with a neurological symptom such as headache, focal neurologic sign, changed mentality and seizure. A retrospective analysis was undertaken to evaluate the frequency of seizure in patients with metastatic brain tumor. Methods: We reviewed the medical records of consecutive 181 patients with metastatic brain tumor. We analyzed the relationship between presence of seizure and various factors: primary origin, size and location of lesions, multiplicity, accompanying hemorrhage and leptomeningeal seeding. In addition, the response to anticonvulsant agents was analyzed. Statistical evaluation was carried out using the Chi-square test with p values of <0.05 considered to be statistically significant. Results: Twenty-nine (16%) of patients had least one episode of seizure. The presence of seizure was significantly associated with multiplicity and leptomeningeal seeding. The patients with metastasis involving cerebral cortices had more seizure (17.8% versus 6.9%), but not statistically significant. The size of tumors, accompanying hemorrhage and primary origin did not influence the occurrence of seizure. Among patients with seizures, seizures were well controlled by single anticonvulsants in twenty (69%), and nine patients were treated with two or more anticonvulsants. No variables were associated with seizure control. Conclusions: Epilepsy in brain metastases is less common than in primary brain tumor, and it is relatively well controlled by anticonvulsant agents.