Seizures in lung transplant recipients

Area of Science:

• Neurosurgery
• Transplant Surgery
• Neurology

Background:

• Organ transplant recipients have an increased risk of seizures.
• Lung transplant patients are a population with significant seizure risk.

Purpose of the Study:

• To assess the incidence and potential causes of seizures in lung transplant recipients.
• To identify risk factors associated with seizures in this patient group.

Main Methods:

• Retrospective review of 85 lung transplants in 81 patients (1991-1994).
• Analysis of patient demographics, seizure characteristics, neurological exams, medications, and laboratory results (including cyclosporine levels, EEG, and brain imaging).

Main Results:

• 22% (18/81) of patients experienced seizures.
• Younger patients (<25 years) and those with cystic fibrosis had a higher risk.
• Seizures often occurred within 10 days of intravenous methylprednisolone treatment for rejection (61%).
• Brain MRI showed increased T2 signal in 8/9 patients.

Conclusions:

• Multiple factors contribute to seizures in lung transplant recipients.
• Intravenous methylprednisolone for rejection may increase seizure risk, especially in younger patients.
• Focal blood-brain barrier disruption is hypothesized to play a role in seizure development.