THE EFFECT OF TUMOR-ASSOCIATED EPILEPSY ON PERFORMANCE HANDICAP SCALES USED IN CEREBRAL GLIOMA

The sensitivity of three scales of performance and handicap to the pre sence and development of epilepsy in patients with brain tumours was s tudied. Two hypothetical cases had equivalent disability, in one case due to epilepsy and in the other to physical impairment. The second ca se later developed epilepsy. All consultant neurologists and neurosurg eons in Scotland were asked to grade the cases using three scales comm only used for patients with cerebral glioma. Consultants rated the pat ient with epilepsy alone as being less disabled and handicapped than t he patient with physical impairment without seizures (sign test p < 0. 003). At best 21% of clinicians (p = 0.03) were able to report a chang e in performance score in the second case when seizures developed. The se scales do not reflect changes in handicap and performance associate d with tumour associated epilepsy. Clinical trial protocols for treatm ents for brain rumours must state how performance and handicap related to epilepsy will be measured.