Brain/Central Nervous System Tumours
- Subacute progressive neurological deficit (including personality or behavioural change) in the absence of previously diagnosed or suspected alternative disorders.
New onset seizures characterised by one or more of the following:
- Focal seizures.
- Significant post-ictal focal deficit (excluding confusion).
- Epilepsy presenting as status epilepticus.
- Associated inter-ictal focal deficit.
- Associated preceding persistent headache of recent onset.
- Seizure frequency accelerating over weeks or months.
- Headache with vomiting and papilloedema.
- Consider urgent referral for patients with non-migrainous headaches of recent onset, when accompanied by features suggestive of raised intracranial pressure (e.g. woken by headache; vomiting; drowsiness), progressive neurological deficit or new seizure.
The probability of having a brain tumour in the following situations is as follows:
- New onset seizure (any type) in adults 2-6%
- New onset status epilepticus >10%
- Chronic daily headache, without features of raised intracranial pressure <1%
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