ArticleNeuro-oncology2011
Peri-ictal pseudoprogression in patients with brain tumor.
Article in Neuro-oncology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 46 citations in OpenAlex.
- Post-therapy imaging of adult brain tumours: patterns, pitfalls, and practical framework.Insights into imaging · 2026Article
- Neurological Puzzles After Radiotherapy: Mysterious Clues of Smart Syndrome, Two Case Reports.Journal of clinical ultrasound : JCU · 2026Article
- Seizure-Related Deterioration in Treated Glioma: A Narrative Review of Nonconvulsive Status Epilepticus, Peri-Ictal Pseudoprogression, Treatment-Related Change, and True Progression.Diagnostics (Basel, Switzerland) · 2026Review
- Peri-ictal magnetic resonance imaging findings in pediatric seizures: a scoping review on pearls and pitfalls from a heterogeneous population.Translational pediatrics · 2026Review
- Epilepsy in Patients with Cerebral Radiation Necrosis: A Scoping Review.Medicina (Kaunas, Lithuania) · 2026Article
- Case Report: longitudinal imaging in a patient with SMART syndrome after cranial radiotherapy.Frontiers in oncology · 2026Article
- Imaging of Status Epilepticus.Journal of clinical medicine · 2025Review
- Tumour mimics in paediatric neuroimaging.Neuroradiology · 2025Review
- Article
- Positron Emission Tomography and Magnetic Resonance Imaging Findings in the Diagnosis of Stroke-Like Migraine Attacks after Radiation Therapy Syndrome: A Case Report.Advances in radiation oncology · 2024Article
- Post-ictal changes presenting as late pseudoprogression on MRI and PET in a patient with diffuse glioma: Case report and brief literature review.The neuroradiology journal · 2024Review
- Postoperative disappearance of leptomeningeal enhancement around the brainstem in glioblastoma.Neuroradiology · 2024Article
- Comprehensive Update and Review of Clinical and Imaging Features of SMART Syndrome.AJNR. American journal of neuroradiology · 2023Review
- Neurological side effects of radiation therapy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Review
- Prognostic Factors of Stroke-Like Migraine Attacks after Radiation Therapy (SMART) Syndrome.AJNR. American journal of neuroradiology · 2022Article
- Perfusion imaging with arterial spin labeling (ASL)-MRI predicts malignant progression in low‑grade (WHO grade II) gliomas.Neuroradiology · 2021Article
- Late effects of cancer treatment: consequences for long-term brain cancer survivors.Neuro-oncology practice · 2021Review
- Glioblastoma with brainstem leptomeningeal pseudoprogression following radiation therapy.Radiology case reports · 2019Article
- Stroke-Like Migraine Attacks after Radiation Therapy Syndrome: Clinical and Imaging Characteristics.Journal of clinical imaging science · 2019Article
- Stroke-like migraine attacks after radiation therapy (SMART) syndrome is not always completely reversible: a case series.AJNR. American journal of neuroradiology · 2013Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recent advances in the treatment of malignant gliomas have highlighted the fact that the appearance of new contrast-enhancing lesions on magnetic resonance imaging (MRI) is not always indicative of tumor recurrence. It has been suggested that transient seizure-related MRI changes could mimic disease progression (peri-ictal pseudoprogression [PIPG]). However, the clinical and MRI features associated with this situation have not been well described. Here, we consulted the databases of 6 institutions to identify patients with brain tumor who presented during the follow-up period transient MRI lesions wrongly suggesting tumor progression in a context of epileptic seizures. Ten patients were identified. All patients but 1 were long-term survivors who had initially been treated with radiotherapy. The PIPG episode occurred after a median interval of 11 years after radiotherapy. MRI features were highly similar across patients and consisted of transient focal cortical and/or leptomeningeal enhancing lesions that erroneously suggested tumor progression. All patients improved after adjustment of their antiepileptic drugs and transient oral corticosteroids, and MRI findings were normalized 3 months after the PIPG episode. Two patients demonstrated several seizure relapses with the same clinicoradiological pattern. After a median follow-up period of 3.5 years after the initial PIPG episode, only 1 patient presented with a tumor recurrence. In conclusion, in patients with brain tumor, especially in long-term survivors of radiotherapy, the appearance of new cortical and/or leptomeningeal contrast-enhancing lesions in a context of frequent seizures should raise the suspicion of PIPG. This phenomenon is important to recognize in order to avoid futile therapeutic escalation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.