Tuesday, October 28, 2008

New information on Seizures....

Author: FT Mangano, AE McBride, and SJ Schneider
Brain tumors are a common cause of epilepsy in adults. More than one-third of the 35,000 patients per year with newly diagnosed brain tumors develop epileptic seizures. If the tumor involves the cerebral hemispheres, seizures occur in at least 50% of cases.17,18
Some predictive factors for seizure occurrence include:81,83
tumor location in the frontal or parietal regions
evidence of cerebral hemispheric dysfunction
incomplete tumor resection
Any brain tumor, benign or malignant, common or uncommon, can cause seizures.19–23 Those more highly associated with the development of epilepsy include:83,88
hemorrhagic lesions
multiple metastases
slowly growing primary tumors
tumors near the Rolandic fissure
Patients with low-grade tumors may be more likely to develop epilepsy, possibly because their longer survival allows more time for seizures to develop.81 One retrospective study found a median interval of 8 weeks between diagnosis of a brain tumor and a first seizure.83
The tumors most often presenting with seizures in adults are:24–30
dysembryoplastic neuroepithelial tumors (DNETs) 90-100
glioblastoma multiforme34
low-grade astrocytoma69
metastatic tumors41
Epilepsy in children is associated with brain tumors less often than in adults. Tumors still must be ruled out, however, even if the child has no neurologic deficits.32–34 If a tumor is diagnosed, up to 46% of these patients may have intractable seizures.32,35,36 Most tumors occur in the temporal or frontal lobes. As in adults, epileptogenic brain tumors in children may be benign or malignant. The most common tumors associated with epilepsy in children are:30,36–38
low-grade astrocytomas

OK, so you may be asking why did I post this. My doctor thinks I'm nuts. She doesn't think that I had a seizure at all. She just thinks that this is the way my life is going to go. She did order an EEG for tomorrow morning and then I go back to see her again in two weeks. I asked her if this is going to be the norm for me and she said yes, the new normal. I asked her if I'm looking more at Quality vs Quantity now and she also said yes. So, here I am. Now what? I started crying in her office. I told her I want to go back to work but that I'm scared. I'm scared to have a seizure or to slur my words or forget my way. She asked me if I applied for SSDI yet and I told her yes. She said good. One thing that I need to understand is that Neurologists and Neurosurgeons don't really have personalities. They are extremely smart but no real people skills.
I go in for an EEG tomorrow morning to see if I am having any detectable seizures and then back to my Neurologist in two weeks to see the results. I really don't know what I'm hoping for.

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