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Purpose: We investigated, whether epileptic seizures (ES) as presenting symptom in adult patients with GBM are associated with better Overall Survival (OS) compared to ES presenting later during the course of GBM, and efficacy and safety of different antiseizure medications (ASMs).Methods: Retrospective consecutive cohort study of adults with GBM: 50 from Norway and 50 from Italy. We compared the time to changing ASM treatments. OS was investigated with a Cox regression model adjusted for time dependency.Results: Median follow-up was 17 months from GBM diagnosis. ES were the presenting symptom in 49 patients. All patients received ASM treatment. LEV was the first ASM in the majority of patients and the most effective at one year from the first prescription, (p = 0.004). Occurrence of adverse events (AEs) was similar between LEV and other ASMs (p = 0.47). Poorer OS correlated with older age at GBM diagnosis, country and ASM therapy. A negative impact of ASMs on OS was observed for LEV in a univariate and multivariate analysis, and for VPA (only in multivariate analysis), even when adjusted for O6-methylguanine-DNA-methyltransferase (MGMT) methylation status. Patients with ES as the onset symptom of GBM and patients who had first ES later had similar OS (p = 0.87).Conclusion: ES as the GBM debut symptom did not lead to a longer OS. LEV was a more effective ASM compared to other treatments with no differences regarding AEs between LEV and other ASMs. Surprisingly, in our patients LEV and VPA were associated with worse OS than other ASMs. This result should be interpreted with caution due to the retrospective nature of this study along with the many variables which may affect the outcome in this population. [ABSTRACT FROM AUTHOR]

Purpose: Epilepsy is common in glioma patients, but clinical data on the course of status epilepticus (SE) in this group are sparse. The aim of this study was to investigate the relationship of SE to tumor grading, seizure semiology, trigger factors, treatment response, recurrence and outcome of SE in patients with glioma.Methods: Adult patients with SE and glioma WHO grade II-IV were identified from a prospective clinical study at two neurological departments. We identified 31 SE in 20 patients during a period of 7 years.Results: SE was more frequent in patients with high-grade glioma. Half of the seizures were secondary generalized. Patients with a clinical and radiological stable glioma had SE as often as patients with untreated tumor or tumor in progression. The majority of patients had a well-controlled epilepsy prior to SE. SE responded well to first and second line treatment. Patients with SE and tumor progression were not more refractory to treatment than patients without progression.Conclusion: SE secondary to glioma responded well to treatment and should be treated aggressively regardless of the oncological prognosis. Seizures during tumor progression were not more treatment refractory than SE in patients with stable glioma disease. [ABSTRACT FROM AUTHOR]

Abstract: Background and purpose: The aim of this study was to estimate the rate of neurological adverse effects following radiotherapy for testicular seminoma and to disclose possible dose-related effects. Patients and methods: All seminoma patients treated 1980–2001 at our department with radiotherapy as the only treatment modality following orchiectomy constitute the study group (median follow-up 10 years). Since 1980, clinical data including possible side effects have systematically been recorded in these patients. These records were used to identify men with possible neurological adverse effects. Univariate logistic regression was used to estimate dose-related effects. Results: Overall, 11 men (3.2%) with neurological symptoms probably related to radiotherapy were identified. Seven men treated with 25.2–36 Gray presented with sensory symptoms about 2 months following radiotherapy. These symptoms resolved in all but one after 1–3 months. The remaining four men (dose 36–40 Gray) had motor impairment which lasted at least one year, but none had persistent pareses at long-term follow-up. There was a statistically significant increase in rate of motor symptoms with higher dose. Conclusions: Although motor impairment is unlikely to occur at current standard doses for seminomas, physicians should be ware of the sensory symptoms these men may exhibit. [Copyright &y& Elsevier]

The expression of CD59 and other complement regulators was studied in human cerebellum from 14 individuals with no cerebellar pathology, from one patient with multiple sclerosis (MS) and from two patients with paraneoplastic cerebellar degeneration (PCD). CD59 was present on the Purkinje cells at various levels in eight of the 14 cases with no cerebellar pathology. CD59 was also present on the Purkinje cells of the patient with MS, but not on the scarce remaining Purkinje cells of the two patients with PCD. Other complement regulators (CD35, CD46 and CD55) were not expressed on the Purkinje cells, whereas CD59, CD46 and CD55 were present on the molecular, granulosa and endothelial cells. The results suggest that Purkinje cells not expressing CD59 could be especially prone to complement-mediated damage. [Copyright &y& Elsevier]

Background Paraneoplastic neurological syndromes (PNS) are poorly described in patients without onconeural antibodies and in patients with non-small cell lung cancer (NSCLC). We compared the clinical characteristics of PNS in lung cancer patients with and without onconeural antibodies. Methods Medical records from patients with lung cancer and neurological symptoms referred for onconeural antibody analysis in the period 1995–2004 were analyzed and well-established diagnostic criteria used for the retrospective diagnosis of PNS. Thirty-one patients were diagnosed with PNS and included in the study. Data from the Cancer Registry of Norway and follow-up medical data were analyzed. Results Small-cell lung cancer (SCLC) was the most common lung cancer in the 31 PNS patients (77%, P < 0.01). Onconeural antibodies were found in 18 of the PNS patients (58%). Paraneoplastic encephalomyelitis (PEM) was the most common PNS among the seropositive patients (11 of 18 patients), of which 10 had SCLC. Various types of PNS were found in the 13 seronegative patients. Conclusion Approximately 40% of PNS patients with lung cancer do not have onconeural antibodies. PEM was the most common PNS in the seropositive patients. Our results underline the importance of recognizing PNS in patients with NSCLC and those without onconeural antibodies. [ABSTRACT FROM AUTHOR]