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Acute mental status changes in children with systemic cancer
1Division of Neurology, Children's Hospital of Philadelphia.
Pediatrics
|March 1, 1990
Summary
Acute changes in mental status (AMS) affect 11% of children with cancer, often caused by seizures, encephalopathy, or stroke. Outcomes depend on the cause, with difficult-to-control seizures leading to long-term therapy needs.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Clinical Neurology
Background:
- Acute changes in mental status (AMS) are a significant complication in pediatric cancer patients.
- These changes stem from various cancer- and treatment-related factors.
- Understanding the incidence, causes, and outcomes of AMS is crucial for patient management.
Purpose of the Study:
- To determine the incidence of AMS in children with cancer.
- To identify the primary etiologies of AMS in this population.
- To evaluate the outcomes associated with different causes of AMS.
Main Methods:
- Retrospective review of medical records for children under 18 with systemic cancer (excluding primary CNS tumors) experiencing AMS.
- Data collected from 1981 to 1987.
- Analysis of cancer type, treatment, timing of AMS, etiology, and patient outcomes.
Main Results:
- AMS developed in 11% (89 of 815) of at-risk children.
- Seizures were the most common cause (60%), followed by encephalopathy (27%) and stroke syndrome (13%).
- Incidence varied by cancer type, with leukemia patients most affected (14%).
Conclusions:
- AMS is a notable complication in pediatric cancer patients, with diverse etiologies.
- The specific cause of AMS significantly influences neurological morbidity and mortality.
- Prompt identification and management of AMS, particularly seizures, are vital for improving patient outcomes.