Incidence of neurologic deficits and rehabilitation of patients with brain tumors.

OBJECTIVE: To report and discuss common neurologic problems in adults with brain tumors admitted for inpatient rehabilitation at an acute rehabilitation center.

DESIGN: Retrospective, descriptive, case series of 51 consecutive adult patients (65% male), with a variety of tumor types (31.3% glioblastoma, 25.5% meningioma, and 25.5% metastatic). Outcome measures were the functional status as measured by the FIM scores, the length of rehabilitation stay, and discharge dispositions.

RESULTS: The most common deficit was impaired cognition (80%), followed by weakness (78%), visual-perceptual deficit (53%), sensory loss (38%), and bowel and bladder dysfunction (37%). Less common problems, in decreasing incidence, were cranial nerve palsy, dysarthria, dysphagia, aphasia, ataxia, and diplopia. Thirty-eight (74.5%) patients had three or more concurrent neurologic deficits, and 20 (39.2%) patients had five or more deficits. Concurrent deficits among patients with hemi- and tetraparesis involved cognition (n = 29 patients), visual-perceptual function, sensation, cranial nerve palsy, and neurogenic bowel/bladder. The average admission FIM score of 67.2 increased to 87.1 at the time of discharge, with similar gains between patients with primary brain tumor and metastatic disease. Thirty-five patients were discharged home, seven to a nursing home, and one to hospice care; there were eight acute transfers.

CONCLUSIONS: Impaired cognition, weakness, and visual-perceptual deficits were the most common problems in this study population. Our study supports the benefits of comprehensive and interdisciplinary rehabilitation for patients with primary as well as metastatic brain tumors.