Long-Term Outcome and Risk Factors for Uncontrolled Seizures After a First Seizure in Children With Hematological Malignancies

Khan, Raja B.; Morris, E. Brannon; Pui, Ching‐Hon; Hudson, Melissa M.; Zhou, Yinmei; Cheng, Cheng; Ledet, Davonna S.; Howard, Scott C.

doi:10.1177/0883073813488675

Cited by 17 publications

(18 citation statements)

References 20 publications

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“…Children with ALL treated with various protocols have had an incidence of seizures between 1.5% and 13% (1)(2)(3)(4)25) . Epilepsy has previously been described as outcome of ALL patients with seizures, but the reported frequency varies presumingly due to different treatment protocols, use of neurotoxic cranial irradiation in previous studies and different length of follow up of patients (1,25,26) . Likewise, reports on recurrence of seizures under chemotherapy after first manifestation of neurotoxicity vary (25,26) .…”

Section: Discussionmentioning

confidence: 99%

“…Epilepsy has previously been described as outcome of ALL patients with seizures, but the reported frequency varies presumingly due to different treatment protocols, use of neurotoxic cranial irradiation in previous studies and different length of follow up of patients (1,25,26) . Likewise, reports on recurrence of seizures under chemotherapy after first manifestation of neurotoxicity vary (25,26) . The most common underlying etiologies for seizures reported by now have been leukoencephalopathy, cerebral infarction, hypertension, or metabolic disturbances (25,(27)(28)(29) .…”

Section: Discussionmentioning

confidence: 99%

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Seizures during treatment of childhood acute lymphoblastic leukemia: A population-based cohort study

Anastasopoulou

Heyman

Eriksson

et al. 2020

European Journal of Paediatric Neurology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Seizures during treatment of childhood acute lymphoblastic leukemia: A population-based cohort study

Anastasopoulou

Heyman

Eriksson

et al. 2020

European Journal of Paediatric Neurology

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“…They can occur both as an isolated symptom, together with various other CNS toxicities (for example, intracranial hemorrhage or thrombosis, PRES, or MTX-SLS), or second to electrolyte and metabolic disturbances or to infections. Many patients subsequently require long-term anti-convulsive therapy, female sex being a significant risk factor 52 .…”

Section: Central Neurotoxicitymentioning

confidence: 99%

Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy

et al. 2017

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During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy (or both), bone toxicities (including osteonecrosis), thromboembolism, sinusoidal obstruction syndrome, endocrinopathies (especially steroid-induced adrenal insufficiency and hyperglycemia), high-dose methotrexate-induced nephrotoxicity, asparaginase-associated hypersensitivity, pancreatitis, and hyperlipidemia. Few of the non-infectious acute toxicities are associated with clinically useful risk factors, and across study groups there has been wide diversity in toxicity definitions, capture strategies, and reporting, thus hampering meaningful comparisons of toxicity incidences for different leukemia protocols. Since treatment of acute lymphoblastic leukemia now yields 5-year overall survival rates above 90%, there is a need for strategies for assessing the burden of toxicities in the overall evaluation of anti-leukemic therapy programs.

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“…Lucchini et al 14 describe 12 children with chemotherapy-associated PRES, 4 (33%) of whom developed unprovoked generalized seizures (2 patients) and/or focal spikes on EEG (2 patients) after 10 to 124 months. In the study of Khan et al, 54 the presence of leukoencephalopathy in children with seizures associated with hematological malignancies did not predict the development of uncontrolled seizures in the subsequent years. In a study of children being treated for acute leukemia, 19 (2.9%) of 648 developed PRES.…”

Section: Pres Associated With Malignant Disease and Chemotherapymentioning

confidence: 85%

Long-term Consequences of the Posterior Reversible Encephalopathy Syndrome in Eclampsia and Preeclampsia

Postma¹,

Slager²,

Kremer³

et al. 2014

Obstetrical &Amp; Gynecological Survey

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This review summarizes the long-term consequences of the posterior reversible encephalopathy syndrome (PRES) that have been described in the obstetric literature (eclampsia and preeclampsia) and compares these with data from the nonobstetric literature. Preeclampsia is characterized by new-onset hypertension and proteinuria after the 20th week of pregnancy. Neurological symptoms include headache; visual deficits; confusion; seizures; and, in the most severe cases, intracranial hemorrhage. Eclampsia is an acute cerebral complication of preeclampsia, defined as the occurrence of tonic-clonic seizures in pregnant or recently postpartum women. With severe preeclampsia, in conjunction with neurological symptoms, or eclampsia, neuroimaging changes consistent with PRES can be seen. Posterior reversible encephalopathy syndrome is a specific clinicoradiological syndrome presenting with headaches, visual impairment, seizures, and altered mental status. Characteristic neuroimaging features are consistent with cerebral edema predominantly in the parietal and occipital lobes. In addition to preeclampsia/eclampsia, PRES has been associated with various conditions in the nonobstetric population, that is, severe hypertension, transplantation, or autoimmune disease, in combination with immunosuppressive therapy or high-dose chemotherapy for various malignant conditions. Long-term sequelae of both preeclampsia/eclampsia and other PRES-related conditions are poorly described. After eclampsia or preeclampsia, nonspecific white matter lesions may be found on magnetic resonance imaging, which may or may not be related to the PRES episode. Previously (pre)eclamptic women report cognitive failures; however, no neurocognitive impairment has been shown so far. Various nonobstetric PRES-related conditions have been described with long-term neuroimaging abnormalities as well as cognitive problems, epilepsy, or visual impairment. Although no firm conclusions can be drawn because of the heterogeneity of reported cases, some general comments can be made. Because most persistent long-term problems are present in the nonobstetric population, the main determinant for these long-term problems may be the underlying condition that gave rise to the PRES episode. In addition, most reports suggest that late diagnosis or inadequate therapy may contribute, emphasizing the need for early recognition, adequate treatment, follow-up, and support.

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Long-Term Outcome and Risk Factors for Uncontrolled Seizures After a First Seizure in Children With Hematological Malignancies

Cited by 17 publications

References 20 publications

Seizures during treatment of childhood acute lymphoblastic leukemia: A population-based cohort study

Seizures during treatment of childhood acute lymphoblastic leukemia: A population-based cohort study

Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy

Long-term Consequences of the Posterior Reversible Encephalopathy Syndrome in Eclampsia and Preeclampsia

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