Tumor Type, Epilepsy Burden, and Seizure Documentation: Experiences at a Single Center Neuro-Oncology Clinic

Abstract

\n Purpose: Patients with both primary and metastatic brain tumors have significant seizure burden due to their tumor. We aim to describe seizure incidence in patients seen in neuro-oncology clinical practice. In addition, as the management of tumor related epilepsy (TRE) may require collaboration between subspecialists, documentation regarding seizures and AEDs is evaluated.Methods: This is a retrospective review of patients with a primary brain tumor or brain metastases seen in a neuro-oncology clinic in a 30 day period. A total of 356 unique patients were used in the descriptive analysis of seizure burden. 199 of these patients had TRE and were included in the analysis of seizure documentation. Results: Of the full cohort of patients, 55.3% (197/356) had TRE. The most common primary tumor was glioblastoma (GBM) (35.7%) and the most common metastatic tumor was breast cancer (51.2% of metastatic tumors). Of all tumor types, anaplastic astrocytomas had the highest percentage of patients with TRE (42.9%).The analysis of seizure documentation in patients with TRE revealed that the majority of notes (90.9%) mentioned seizures; however, fewer notes provided seizure frequency (51.3%), seizure descriptions (39.7%) or commented on AED regimens (58.3%).Conclusion: This study defines a representative cohort of patients seen in neuro-oncology clinic. Among patients with TRE, details regarding seizures and antiepileptic regimens are often not documented in clinic notes. Improved documentation could facilitate further research in this population and impact patient care.