Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dissemination of tumor to the leptomeninges and cerebrospinal fluid represents a common pattern of metastasis for many cancers; however, few chemotherapeutic agents are available for intrathecal (i.t.) use and treatment results are often poor. We studied the neurotoxicity and pharmacokinetics of i.t. 4-hydroperoxycyclophosphamide (4-HC) in the rabbit and the activity of i.t. 4-HC in a VX2 rabbit model of leptomeningeal carcinomatosis to evaluate the potential use of 4-HC in the treatment of leptomeningeal tumors. Toxicity studies examined 4-HC doses ranging from 0.5 to 6.0 mumol administered by intraventricular injection weekly for 4 to 8 weeks. Clinical or histological neurotoxicity was not observed in rabbits treated with < 1.0 mumol 4-HC for 4 weeks. Clinical toxicity, characterized by lethargy, weight loss, seizures, or death, was apparent at doses > 2.0 mumol. Vasculitis of superficial arteries was observed in rabbits treated with > 1.0 mumol 4-HC. In cerebrospinal fluid pharmacokinetic studies, the mean drug half-life after intraventricular or intralumbar administration was 24.3 and 18.2 min. Regional inequities in drug exposure were apparent as area under the clearance curve values for cerebrospinal fluid distant from the injection site were lower than those of proximate sites (P < 0.001). Weekly intraventricular treatment of VX2 leptomeningeal tumor-bearing rabbits with 0.5 or 1.0 mumol of 4-HC resulted in an increased life span of 22.5 and 35%, respectively. These results indicate that i.t. 4-HC, at doses lower than those producing neurotoxicity in the rabbit, is effective treatment for VX2 leptomeningeal carcinomatosis.
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PMID:Intrathecal 4-hydroperoxycyclophosphamide: neurotoxicity, cerebrospinal fluid pharmacokinetics, and antitumor activity in a rabbit model of VX2 leptomeningeal carcinomatosis. 142 60

Head and neck cancer has rarely been reported to be a cause of meningeal carcinomatosis. These tumors are known more for their local invasiveness rather than distant metastasis. This would appear to preclude meningeal involvement, but close proximity to multiple cranial nerves may provide an access to the meninges. Six cases of head and neck cancer with meningeal invasion are presented. All six cases had malignant cells in their cerebrospinal fluid. Three cases had malignant cells recovered from a ventricular specimen after lumbar punctures were negative. The most common clinical finding on presentation was cranial nerve involvement. The optic nerve was involved most often with nerves VI and V the next most frequent. Headache was present in four patients and seizures occurred in two. No patient had meningismus. Our current treatment plan involves insertion of an Ommaya Reservoir and intraventricular methotrexate. Only patients whose primary head and neck tumor shows a response to systemic therapy undergo Ommaya placement. Meningeal carcinomatosis in head and neck cancer may be more prevalent than previously thought and the likely mechanism is via direct extension rather than hematogenous spread.
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PMID:Meningeal carcinomatosis in head and neck cancer. Report of six cases and review of the literature. 377 15

A 38 year old patient developed multiple cranial nerve palsy, seizures and progressive alteration in consciousness. CSF examination revealed tumor cells and a tentative diagnosis of leptomeningeal carcinomatosis from an unknown primary tumor was made. Treatment with intrathecal methotrexate and cranial radiation therapy was started without effect. At autopsy widespread leptomeningeal gliomatosis originating from a previously unknown astrocytoma of the hippocampus was found.
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PMID:Diffuse primary leptomeningeal gliomatosis. 845 62

Meningeal carcinomatosis is an uncommon complication in patients with advanced gastric cancer. We report four cases of meningeal carcinomatosis occurring 18 months (mean) after the diagnosis. The presenting manifestations were headache, visual troubles and seizure. Cytological cerebrospinal fluid (CSF) examination was the most useful diagnostic tool for leptomeningeal carcinomatosis, considering the normality of brain CT scan and MRI in our patients. Intrathecal methotrexate administration achieved a rapid improvement in neurological symptoms in all cases, but for a short 2-3 months duration. We conclude that survival improvement in advanced gastric cancer, due to chemotherapy, may allow emergence of unusual complications such as carcinomatous meningitis. This diagnosis should be evoked in the presence of unexplained neurologic symptoms and confirmed by CSF examination in order to propose a treatment and to delay serious neurologic disability and prolong survival.
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PMID:[Meningeal carcinomatosis in gastric cancer]. 1144 30

Rhabdoid meningioma (RM) is a recently described, aggressive variant of meningioma. The authors report a case of RM occurring in the resection cavity of an unrelated neurosurgical procedure, temporal lobectomy for intractable seizures. The patient presented with intractable headache 10 years after the temporal lobectomy. Imaging revealed a dura-based, uniformly enhancing lesion within the resection cavity. She underwent gross-total resection and the findings of the surgical pathological report were consistent with an RM, with a dramatically elevated MIB-1 index of approximately 50%. The patient's clinical course was complicated by severe pain and communicating hydrocephalus secondary to rapid dissemination of malignant cells throughout the CSF pathways. Despite aggressive measures, including tumor resection, ventriculoperitoneal shunt placement, and the initiation of conventional radiation therapy, the ensuing leptomeningeal carcinomatosis proved to be rapidly fatal.
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PMID:Rhabdoid meningioma occurring in an unrelated resection cavity with leptomeningeal carcinomatosis. Case report. 1573 68

Diffuse cerebellar meningeal carcinomatosis secondary to haematogenous dissemination from an anaplastic solid mammary carcinoma was diagnosed in an old German shepherd dog suffering from seizures and rapidly progressing to stupor. A single computed tomography cerebellar scan identified an unusual homogeneous density area that was considered to be associated with a vascular disorder, in the absence of space-occupying lesions. At necropsy, nodular masses were observed in the mammary gland, lungs, tracheobronchial lymph nodes and adrenals. Cerebellar leptomeninges were affected by diffuse blood effusion. Histology showed a solid mammary tumour, characterised by anaplastic cells with a cytoplasmic keratin-positive and vimentin-negative immunoreaction. The tumour had spread to the lungs, tracheobronchial lymph nodes and adrenals. Cerebellar leptomeninges were diffusely infiltrated by the cytokeratin-positive neoplastic cells. Even though computed tomography scan gave no evidence of meningeal carcinomatosis, it was considered that a cerebellar vascular disorder might be present. This was subsequently confirmed by neuropathological investigation and seen to be associated with a cerebellar leptomeningeal carcinomatosis.
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PMID:Cerebellar leptomeningeal carcinomatosis in a dog. 1760 59

Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 49-year-old woman was admitted to our hospital with the symptoms of headache and melena for 10 days. The endoscopy showed a thickening of the folds of the stomach compatible with the diagnosis of a Borrman type IV gastric cancer. The biopsy revealed a signet ring cell carcinoma. The MRI of brain showed no abnormal findings; however, the patient complained of an intractable persistent headache, nausea and vomiting on admission day 6. The cytology examination of the cerebrospinal fluid supported the diagnosis of metastatic signet ring cell carcinoma.
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PMID:A case of gastric adenocarcinoma presenting as meningeal carcinomatosis. 1830 94

Cancer in the central nervous system can arise from a primary brain tumor and metastasize to the brain or to the leptomeninges, leading to leptomeningeal metastasis (LM). LM also is called leptomeningeal carcinomatosis and carcinomatous meningitis. When LM occurs, signs and symptoms include headache, nausea, vomiting, lumbar back pain, and stiff or painful neck; LM also may lead to mental disturbances and seizures. Nursing care of patients with LM requires an understanding of neurologic anatomy and physiology, along with associated treatments and complications. Treatment of LM may involve intrathecal or, more likely, intraventricular chemotherapy. Very little has been written about appropriate care of patients with LM. The purpose of this article is to review the literature, summarize clinical care recommendations, and construct evidence-based guidelines for the administration of intraventricular chemotherapy and the care and monitoring of patients with LM.
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PMID:Management of adult patients receiving intraventricular chemotherapy for the treatment of leptomeningeal metastasis. 1851 41

A 12-year-old female spayed Labrador Retriever was presented with a history of seizures and abnormal vocalization. Approximately 1 year before presentation, multiple mammary cysts had been surgically excised. A mammary mass was noted on physical examination, and 2 separate parenchymal brain lesions were found on imaging studies. Cerebrospinal fluid (CSF) collected from the cisterna magna was analyzed, and abnormalities included moderate pleocytosis with atypical discrete round cells that occasionally formed loose clusters. The dog was euthanized, and on necropsy a primary solid mammary carcinoma was identified as well as multiple metastatic foci in the brain with diffuse meningeal involvement. The cells in the CSF had a morphologic appearance similar to the cells in the primary mammary tumor and in the metastatic tumors in the brain. On immunostaining, cells from the primary mammary tumor, the brain tumors, and the CSF expressed cytokeratin. The CSF cells did not express CD18, CD3, or CD79a. A final diagnosis of mammary carcinoma with brain metastasis and meningeal carcinomatosis was made.
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PMID:Neoplastic pleocytosis in a dog with metastatic mammary carcinoma and meningeal carcinomatosis. 2007 Jun 45

A six-year-old cross breed dog was presented with a four-month history of seizure activity, which was unresponsive to anticonvulsive therapy and an acute deterioration in neurological status, evident as central blindness. Cyst-like structures and nodular enhancement within the subarachnoid space were shown on a magnetic resonance image (MRI) scan. Histopathological examination of brain tissue was consistent with meningeal carcinomatosis.
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PMID:Meningeal carcinomatosis in a dog: magnetic resonance imaging features and pathological correlation. 2013 9


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