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Managing Cancer Care

Seizures

A seizure is the uncontrolled movement of muscles. It can happen when nerve cells in the brain become irritated, overexcited, or something puts pressure on them so they don’t work properly. Seizures usually last a few minutes or less, but they can be followed by sleepiness and confusion that can last for several hours or days.

Seizures in cancer patients can be caused by:

  • Certain types of chemotherapy, especially when it is given through the spine (spinal or epidural) or into a port in the scalp (intrathecal)
  • Tumor growth in the spine or brain
  • Surgery, injury, or trauma to the head
  • Swelling in the brain
  • High fevers
  • Blood clots
  • Serious infections of the fluid around the spine and brain
  • Changes in electrolytes (blood chemistries), such as calcium and sodium levels
  • Other non-cancerous conditions and drugs

What to look for

  • Eyes stare blankly or roll back
  • Patient might suddenly lose control of urine and bowels
  • Jerking movements of the body, especially the arms and legs

What the patient can do

  • Talk to your cancer care team about your risk for seizures and any history of having seizures in the past.
  • If you have a seizure while being cared for by the cancer care team, bring a person who saw your seizure with you to answer any questions about it.
  • If they are needed, take anti-seizure medicines as prescribed.

What caregivers can do

  • Give anti-seizure medicine as prescribed.
  • Keep the patient safe. If a seizure starts while the patient is in bed or on a chair, try to protect the patient from falling to the floor and hitting their head.
  • Use side rails and bumper pads on the bed as needed. Be sure someone is with the patient when they’re walking or sitting in a chair.
  • Stay with the patient and stay calm.
  • Don’t try to open the patient's mouth during a seizure, even if the patient is biting their tongue. Keep your fingers and hands away from the patient’s mouth.
  • Don’t move the patient unless they are in a dangerous location (such as near a hot radiator, glass door, or stairs).
  • Loosen any clothing around the patient’s neck.
  • Try to notice what type of movements the patient makes, time how long the seizure lasts, and what parts of the body move with the seizure.
  • If the patient falls to the floor, put padding (such as rolled-up clothes or towels) under their head and roll them onto their side.
  • If the patient is lying on their back and you can’t roll them, gently turn their head to the side if you can. Don’t force any part of the body to move.
  • Once the seizure is over, cover the patient with a blanket and let them rest.
  • Don’t give medicines, food, or liquids until you call the cancer team and the patient is fully awake.

Call the cancer care team

  • Once the seizure is over and the patient is comfortable
  • If someone else is with you, stay with the patient and have the other person make the call.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Avila EK, Chamberlain M, Schiff D, et al. Seizure control as a new metric in assessing efficacy of tumor treatment in low-grade glioma trials.  Neuro Oncol. 2017;19(1):12-21.

Brown PD, Butts AM, Parsons MW, Cerhan JH.  Neurocognitive effects.  In DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2019: 2155-2173.

Costa J, Haddad FG, Costa G, Harb A, Eid R, Kourie HR, Helou JE. Seizures in cancer patients: A vast spectrum of etiologies. Future Neurology. 2019;14(4):doi:10.2217/fnl-2019-0015.

Yust-Katz S, Khagi S, Gilbert MR. Neurologic complications. In Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:688-.706

 

Last Revised: February 1, 2020

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