Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We analyzed a retrospective series of 195 patients with documented intracerebral metastases (ICM) to assess the frequency of late seizure development and the impact of prophylactic anticonvulsants. Eighteen percent of the patients presented with seizures. Of the remaining patients, 40% received prophylactic anticonvulsants (diphenylhydantoin [DPH] in greater than 90%). Ten percent developed late seizures at an interval from the diagnosis of ICM ranging from 1 to 59 weeks. No patient with a posterior fossa lesion developed seizure; conversely, patients with evidence on initial examination of cerebral hemispheric dysfunction had a higher incidence of late seizure development. The incidence of seizure was virtually identical in patients who received DPH compared with those in whom it was withheld, although two thirds of patients who developed seizure while on DPH had a serum anticonvulsant level that was subtherapeutic. Based on the above findings and until prospective data become available, we recommend that anticonvulsants be withheld in newly-diagnosed patients with ICM until the first seizure.
 ...
PMID:Should prophylactic anticonvulsants be administered to patients with newly-diagnosed cerebral metastases? A retrospective analysis. 317 27

Diphenylhydantoin is a well known anticonvulsant used primarily in the treatment of epilepsy. The prophylactic use of diphenylhydantoin has been suggested for certain cerebral metastases, and it is routinely administered to prevent seizures induced by intracranial neoplasms and/or surgery. Patients with malignant gliomas treated with diphenylhydantoin frequently receive radiation therapy. The effects of a clinical concentration of diphenylhydantoin in combination with gamma radiation was investigated using the C6 astrocytoma cell line in both monolayer and three dimensional multicellular spheroid cultures. Diphenylhydantoin at 7.2 X 10(-5) M (20 micrograms/ml) significantly increased the doubling time (23%) of the C6 astrocytoma cells in monolayer, but did not affect their survival as measured by plating efficiency. No changes were seen in spheroid growth or plating efficiency of the cells dissociated from spheroids at this concentration. Diphenylhydantoin at the clinical concentration tested was not associated with an alteration in radiation sensitivity of C6 astrocytoma cells in monolayer or three dimensional multicellular spheroid cultures.
 ...
PMID:The effects of diphenylhydantoin on murine astrocytoma radiosensitivity. 344 Aug 76

Brain metastases are rare in well-differentiated thyroid carcinoma but when present they can lead to the patient's death. Iodine-131 therapy for intracerebral thyroid carcinoma metastases causes radiation-induced acute cerebral edema that can lead to CNS complications and even death. We present a case in which a patient with intracerebral 131I uptake developed seizures, slurred speech, and muscle weakness 12 hr following 131I therapy. The patient's CT scan, post-therapy, confirmed an intracranial metastasis with a significant amount of surrounding edema. Radiotherapists, when using external beam radiation to treat intracerebral metastases, commonly place these patients on steroids, glycerol, or mannitol prior to instituting therapy, to prevent complications from radiation-induced cerebral edema. This technique could be applied to 131I therapy of intracranial thyroid carcinoma metastases as well.
 ...
PMID:Cerebral edema following iodine-131 therapy for thyroid carcinoma metastatic to the brain. 371 81

A three-year-old girl with disseminated malignant teratoma was treated by palliative radiotherapy to her pulmonary metastases. She developed seizure followed by absence of cerebral function and death ensued in 36 hours. Computerized scan of brain was negative prior to death. The main finding at autopsy was occlusion of the carotid and cerebral arteries by necrotic tumour. Widespread cerebral tumour embolization may be an unusual terminal event in cancer patients with pulmonary metastases.
 ...
PMID:Sudden cerebral death in malignant presacral teratoma. 404 78

The effect of 5 mg of intravenous diazepam (Valium) on contrast media-associated seizure incidence was studied in a randomized controlled trial involving 284 patients with known or suspected brain metastases undergoing cerebral computed tomography. Of these patients, 188 were found to have brain metastases, and it is estimated that for this subgroup prophylactic diazepam reduces the risk of contrast-associated seizure by a factor of 0.26. Seizures occurred in three of 96 patients with metastases on diazepam and in 14 of 92 patients with metastases but without diazepam. Factors related to increased risk of contrast media-associated seizures are: (1) prior seizure history due to brain metastases and/or prior contrast, (2) progressive cerebral metastases, and (3) prior or concurrent brain antineoplastic therapy. Factors not related to an increased risk of these seizures are: (1) contrast media dosage, chemical composition, or osmolarity, (2) computed tomographic appearance of metastases, and (3) type of primary malignancy. Concomitant therapeutic levels of diphenylhydantoin (Dilantin) do not protect completely against contrast media-associated seizures. Pathophysiology of contrast media-associated seizures is discussed in view of the risk factors determined by this study.
 ...
PMID:Diazepam prophylaxis of contrast media-induced seizures during computed tomography of patients with brain metastases. 634 Apr 44

Eighty-one patients with brain metastasis from melanoma were identified at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1978 and 1980. Of 78 evaluable patients, 51 (65%) had multiple brain metastases. Of 64 patients with non-contrast CT scans, 29% had hemorrhagic metastases. Leptomeningeal metastases were found in 15 patients. Patients were grouped into three categories: Group 1, multiple brain metastases treated with radiation therapy (RT) (n = 49); Group 2, single brain metastasis treated with RT (n = 17); Group 3, single brain metastasis treated with surgery with or without RT (n = 9). Median survivals for Groups 1, 2 and 3 were 11, 9 and 41 weeks, respectively. Eighty-six percent, 65% and 33% of patients in Groups 1, 2 and 3, respectively, were steroid-dependent until death. Seizures occurred in 38 patients (48%). In 17 (21%), seizures were the first manifestation of metastasis. Of 51 patients not receiving prophylactic anticonvulsants, 37% had seizures. Of 12 patients treated prophylactically, 17% developed seizures. Surgical extirpation should be considered in highly selected patients with brain metastasis from melanoma. Prophylactic anticonvulsants are recommended if there is no contraindication.
 ...
PMID:Brain metastasis from melanoma. 667 74

A 61-year-old man presented with uniocular gradually progressive visual loss, pain in the eye, visual activity of 6/60, markedly constricted visual fields, optic disc edema, retinal pigment epithelial disturbance at the posterior pole, and markedly delayed filling of the choroid on angiography, with a normal fellow eye. He had suffered from recurrent seizures for 15 years, with some evidence of cortical demyelination. Erythrocyte sedimentation rate was elevated. About 5 months after the onset of visual disturbance, evidence of bronchial carcinoma became apparent and he died 6 weeks later. The etiology of his ocular lesions was established only by histopathological evidence of metastases into the optic nerve head and the choroid. Diagnostic problems presented by the ocular findings are discussed.
 ...
PMID:Unilateral optic nerve head and choroidal metastases from a bronchial carcinoma. 714 34

Based on provisional clinical diagnosis, the choice of computed cranial tomography (CCT) or radionuclide brain scan (RBS) was retrospectively evaluated. In 1,333 selected cases, 551 had CCT only, 560 had RBS only, and 222 had both. CCT was the clinician's preference in cases of dementia, hydrocephalus, hemorrhage, aneurysm, arteriovenous malformation (AVM), primary tumor, visual abnormality, coma, and multiple sclerosis. RBS was preferred in headache, syncope, seizure, transient ischemic attack (TIA), metastatic disease, and encephalitis. Neither procedure appeared preferable in cases of psychosis, psychiatric disease, cerebral vascular accident (CVA), and abscess. Thirty-eight percent of CCTs yielded abnormal findings, not necessarily correlated with the provisional diagnosis. Thirty percent of RBS showed positive findings, mostly related to vascular abnormalities. On the basis of the provisional clinical diagnosis, CCT was more frequently requested for probable structural changes and RBS for probable perfusion abnormalities.
 ...
PMID:Utility of the provisional clinical diagnosis as a basis for selection of computed tomographic or radionuclide brain scan. 727 14

After an initial course of radiation, 56 patients with cerebral metastases had their brain retreated at least once for recurrent neurologic symptoms. The most common primary was from either the lung or breast. The frequent symptoms were headache, weakness, seizures, visual problems, and/or mental changes. Forty-two (75%) of these patients responded to the second course of treatment. The median duration of response was 10 weeks and median survival was 14 weeks.
 ...
PMID:Results of re-irradiation for cerebral metastases. 744 97

A cohort of 8 patients with myxoma of the left atria and neurological manifestations is reported. Cerebral ischaemia, sometimes responsible for epileptic seizures, led to the discover of the myxoma (5 cases) or recurrence after exeresis (1 case) with imaging evidence of cerebral infarction in 5 cases. The first manifestation was a retinal embolism and temporary ischaemia in 1 case and pulmonary embolism with regressive cerebral ischaemia in another case with bilateral myxoma. Some clinical particularities should be underlined including exercise-induced neurological defect (3 cases), systemic embolism associated with cerebral infarction (3 cases), migraine headache as the initial manifestation (1 case) preceding by a pseudolupic syndrome suggesting the possibility of cerebral vasculitis or infectious endocarditis (1 case). The prognosis depends on the risk of recurrent atrial tumour formation (1 case). Metastases are rare. Multiple cerebral aneurysms (3 cases) did not lead to haemorrhagic complications.
 ...
PMID:[Myxoma of the left atrium with neurologic manifestations: 8 cases]. 759 71


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>