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June 2007

Status Epilepticus in Patients With CNS Metastases

Arch Neurol. 2007;64(6):916. doi:10.1001/archneur.64.6.916-a

We read with interest the study by Cavaliere et al.1 We are particularly intrigued by their report of a 30-day mortality rate of 50% in patients with systemic cancer and brain metastases presenting in convulsive status epilepticus (CSE). We have recently reported a series of 4 patients with systemic cancer presenting in de novo nonconvulsive status epilepticus (NCSE) who were diagnosed with metastatic CNS disease via brain imaging at the time of presentation.2 All patients demonstrated improvement in mental status after treatment with anticonvulsants; however, 2 patients died at 5 and 20 days, respectively, after the onset of NCSE. Although the number of patients in our series was small, the 30-day mortality of 50% in patients with NCSE is the same as in the series by Cavaliere et al of 10 patients with systemic cancer and CSE.