New-onset seizures can give early warning of cerebral tumors
MedWire News: New-onset epileptic seizures can be a harbinger of cerebral tumors, a study by UK researchers suggests.
Accordingly, patients who develop seizures may warrant continued surveillance for several years, write Michael Goldacre (University of Oxford) and fellow investigators in the Journal of Neurology, Neurosurgery, and Psychiatry.
Goldacre's team used the Oxford Record Linkage Study and English Hospital Episode Statistics to identify 112,541 children and adults who experienced a first-ever seizure between 1963 and 2005. None had a prior or current diagnosis of cerebral tumor.
Using the same two databases, the team also identified seizure-free individuals, matched for age, gender, location, and date, to serve as controls.
Patients with seizure were nearly 20 times more likely than controls to develop cerebral tumors during follow-up, Goldacre's team reports.
The rate ratios were highest for malignant cerebral tumors, at 25.6 in Oxford and 27.3 in England.
After excluding tumors diagnosed in the first year after the index seizure (to reduce any risk that could be attributed to tumors that were diagnosed but not recorded), the rate ratio for subsequent cerebral tumor was 8.83 in the Oxford database and 7.52 in the England database.
The risk for cerebral tumor development was highest among patients aged 15-44 years at the time of index seizure, and did not differ significantly between men and women.
Importantly, the risk for cerebral tumors remained high over time, at rate ratios of 6.53 in years 5-14 and 3.29 in years 15+ post-seizure in the Oxford database, and 5.27 in years 5-7 in the England database.
"Our study suggests that tumor as an underlying cause for epilepsy may not become apparent for several years after onset, and indicates a need for ongoing vigilance," write Goldacre and co-authors.
"The findings out our study suggest that the investigation and surveillance of adults with new-onset epilepsy may warrant reassessment."
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By Joanna Lyford