Critically ill patients with cancer: A clinical perspective

Table 10 Causes of cancer-related seizure and cancer-related acute hydrocephalus[158]

Causes	Comments
Cancer-related seizure
Low-grade tumors	Glioma and oligodendroglioma have intrinsic epileptogenic activity as a result of their long survival and reduced seizure threshold
High-grade tumors	Usually secondary to necrosis, hemorrhage or edema
Brain metastases	Up to 40%
Tumor location	Cortical tumors and those on epileptogenic areas (e.g., mesial temporal lobe and insula) are associated with intractable epilepsy
Stroke	Ischemic or hemorrhagic
Drug toxicity	Cytarabine, methotrexate, cisplatin, vincristine, cyclophosphamide, anthracyclines
Neoplastic meningitis
Paraneoplastic encephalitis
Central nervous system infections
Electrolytic imbalance	Hyponatremia, hypocalcaemia
Metabolic disorders	Hypoglycemia
Liver or kidney failure
Aggravated preexisting epilepsy	Withdrawal medication
Cancer-related acute hydrocephalus
Stopped CSF flow by tumor obstruction of ventricular system	Colloid cysts, ependymoma, intraventricular meningioma, choroid plexus papilloma or posterior fossa tumor; in adults it is often due to leptomeningeal carcinomatosis and intra-ventricular extension of metastasis
Increased CSF content due to deficit in reabsorption	Venous sinus thrombosis, infectious meningitis, metastatic seeding or subarachnoid hemorrhage

CSF: Cerebrospinal fluid.