To determine the incidence of seizures in post-lung transplant patients, as well as to describe its associated clinical characteristics specifically seizure type, onset after lung transplant and anti-seizure management. Use of electroencephalography (EEG) will likewise be determined.

Neurologic complications including encephalopathy, headaches, stroke and seizures are common after lung transplantation, with incidence ranging from 68-92%. The largest cohort reviewing 81 post lung-transplant patients found that seizures occurred in 22% of patients, with highest risk identified in patients less than 25 years old with cystic fibrosis. There is currently no good evidence to help guide anti-epileptic management for transplant patients. Understanding seizures affecting post-lung transplant patients is important to help guide treatment and potentially improve outcomes.

A retrospective chart review at Temple University Hospital’s Lung Center from 2012-2016 was performed to determine seizure incidence in lung transplant patients. Demographics, indication for transplant, seizure onset, type and etiology were determined. EEG use in this patient population was determined.

Two hundred seventy-five patients who underwent lung transplant between 2012 and 2016 were included in the study, of which nine patients (3%) had seizures. The average age at seizure onset was 64 years old, and the most common indication for transplant was idiopathic pulmonary fibrosis. Over half (55.6%) had seizure onset within one year of transplant, and the most common etiology was found to be stroke (ischemic 44.4%, hemorrhagic 11.1%). Most of the patients were controlled on a single anti-seizure medication. EEG was used in 27% of patients, with the most common indication being concern for seizures in the setting of loss of consciousness, paroxysmal movements and altered mental status.

Seizures in post lung transplant patients are rare, with an incidence of 3%. They often occur in the setting of an underlying structural lesion, most commonly stroke, and are typically controlled on monotherapy.