The Impact of Seizures on Cognition and Health Related Quality of Life in Primary Brain Tumours. — ASN Events

The Impact of Seizures on Cognition and Health Related Quality of Life in Primary Brain Tumours. (#339)

Zebunnessa Rahman 1 , Chong Wong 2 , Mark Wong 1 , Najmun Nahar 1 , Paul Harnett 1 , Andrew Bleasel 2
  1. The Crown Princess Mary Cancer Centre, Westmead, NSW, Australia
  2. Neurology, Westmead Hospital, Sydney, NSW, Australia

Aim: To study the incidence and impact of seizures on cognition and health related quality of life in patients with primary brain tumour.

Methods: We administered; the Montreal Cognitive Assessment tool, Frontal Assessment Battery, Quality of Life in Epilepsy -31 and Functional Assessment in Cancer Therapy-Brain subscale, Hospital Anxiety and Depression Scale and Karnofsky Performance Status and Barthel Index. Patients were described on a single ordinal scale: L1: no epilepsy; L2: no sz in last 6 mo without antiepileptic; L3: no sz last 6 mo on antiepileptic monotherapy; L4: no sz last 6 mo on antiepileptic polytherapy; L5: £3 sz in last 6 mo on antiepileptic mono or polytherapy; L6: > 3 sz in last 6 mo on antiepileptic mono or polytherapy. 

Results: Of 253 patients diagnosed with primary brain tumours. (M: F= 1:2:1, mean age=44) there were 104(41%) patients diagnosed with either seizures or epilepsy.  Of the supratentorial parenchymal tumours (143):  69% of WHO grade I, 76% WHO II, 69% WHO III, 41% WHO IV developed seizures. Grade I, II, III showed highest incidence (P<0.01).

In 43 patients seen prospectively 38 patients were independent, 5 dependent or needing assistance and 64% showed cognitive impairment; 14(70%) in L3 – 6 and 6(30%) in L1-2 (statistically not significant). We did not find the cancer QOL scale for brain tumour or the QOL in epilepsy subscales differed from normative data.  Depression was present in 7 patients and anxiety in 7, not correlated with seizures.

Conclusions: Our preliminary data shows epilepsy is more common with the lower WHO grade tumours as previously described. Our patient group did not show any significant impact of epilepsy on cognition and health related quality of life. The small sample size limits the significance of the results. We continue to collect data