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Unexpected seizure attack in a patient with spinal metastasis diagnosed as posterior reversible encephalopathy syndrome.
MedLine Citation:
PMID:  21892409     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Seizure is a foreseeable risk in patients with brain lesion. However, seizure during treating non-brain lesion is not a familiar situation to neurosurgeon. Posterior reversible encephalopathy syndrome (PRES) is a relatively common situation after systemic chemotherapy. The aim of this study is to make neurosurgeons aware of this potential medical problem. A 52-year-old woman with advanced gastric cancer, presented with low back pain due to spinal metastasis at the 4th lumbar vertebra. Ten cycles of chemotherapy with FOLFOX (5-Fluoruracil/Oxaliplatin) had been completed 23 days ago. Two days before the planned operation, a generalized tonic clonic seizure occurred. She did not have a history of hypertension or seizure. The seizure was stopped with lorazepam 4mg. The brain magnetic resonance (MR) imaging showed high signal changes in both parieto-occipital lobes on the T2-weighted images, and these were partially enhanced, suggesting PRES. The surgery was preceded by treatment with an antiepileptic drug. The MR images, taken 1.5 months after the seizure, showed that the lesion was no longer present. At 3 month follow-up, no additional seizure attack occurred without any seizure medication. The possibility of a seizure attack should be considered if the patient has a history of chemotherapy.
Chang Hyoun Kim; Chi Heon Kim; Chun Kee Chung; Tae-Ahn Jahng
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Publication Detail:
Type:  Journal Article     Date:  2011-07-31
Journal Detail:
Title:  Journal of Korean Neurosurgical Society     Volume:  50     ISSN:  1598-7876     ISO Abbreviation:  J Korean Neurosurg Soc     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-09-05     Completed Date:  2011-11-10     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101467054     Medline TA:  J Korean Neurosurg Soc     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  60-3     Citation Subset:  -    
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
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