Expert: Claes-Gustaf Nordquist, M.D. - 8/29/2010

Question
I have an astrocytoma located near my right motor strip causing focal seizures post 28 days of radiation treatment in May (first radiation treatment in 1997; chemo 2004).  I have begun having focal seizures (been over 10 years since last seizure) despite being on anti seizure meds.  My last two MRIs have shown an increase in white enhancement.  In context, the doctors suggest this is tumor breakdown (75%) as opposed to a change in tumor to malignancy (25%) since I just had the radiation.  Surgery not an option for me - will cause paralysis.  My meds keep getting increased as more focal seizures break through.  I had another one yesterday so once again meds will have to increase again.  Any thoughts or experience with the radiation effects simulating tumor growth (ie causing seizures in my case)?  I have never heard about "tumor breakdown" as a cause or side effect from radiation.  Is this common?  Does this get worse and will it get better?  Thanks for any feedback.

Answer
Well radiation therapy & chemotherapy are both given in order to kill tumor cells and if possible the tumor. So of course there will be some breakdown. But radiation will also induce swelling - like a sun burn of the brain - (you were probably given corticosteroids against that) and that too can indeed increase the risk of seizures like this. You should however discuss this problem with a neurologist.



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