<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0004_s_001"><h3>Background</h3><p>The lifetime risk of patients with brain tumors to have focal epileptic seizures is 10–100%; the risk depends on different histology. Specific guidelines for drug treatment of brain tumor-related seizures have not yet been established.</p></sec><sec id="j_joepi-2016-0004_s_002"><h3>Aim</h3><p>This review addresses the special aspects of antiepileptic drug (AED) therapy in brain tumor-related epilepsy.</p></sec><sec id="j_joepi-2016-0004_s_003"><h3>Methods</h3><p>We analyzed the literature up to December 2015.</p></sec><sec id="j_joepi-2016-0004_s_004"><h3>Results</h3><p>Based on current evidence the management of tumor-related seizures does not differ substantially from that applied to epilepsies from other etiologies. Therefore, the choice of an AED is based, above all, on tolerability and pharmacokinetic interactions with chemotherapeutic drugs. Levetiracetam is recommended by many authors as first-line therapy in brain tumor-related epilepsy. Due to the possibility of interactions, the combination of enzyme-inducing AEDs and chemotherapeutic drugs, is usually not recommended as a first choice. Currently there is no evidence that prophylactic prescription of long-term AEDs in brain tumor-patients who did not present with seizures is justified. Because of the high risk of recurrence, however, AED treatment should be strongly considered after a single brain tumor-related seizure. The decision to withdraw AEDs must carefully consider the risk of seizure recurrence.</p></sec><sec id="j_joepi-2016-0004_s_005"><h3>Conclusion</h3><p>At present levetiracetam is the preferred drug in brain tumor-related epilepsy, especially when drug interactions need to be avoided. In the future we hope to acquire more targeted drugs against this disorder by uncovering its pathogenesis.</p></sec></abstract>

BackgroundThe lifetime risk of patients with brain tumors to have focal epileptic seizures is 10–100%; the risk depends on different histology. Specific guidelines for drug treatment of brain tumor-related seizures have not yet been established.AimThis review addresses the special aspects of antiepileptic drug (AED) therapy in brain tumor-related epilepsy.MethodsWe analyzed the literature up to December 2015.ResultsBased on current evidence the management of tumor-related seizures does not differ substantially from that applied to epilepsies from other etiologies. Therefore, the choice of an AED is based, above all, on tolerability and pharmacokinetic interactions with chemotherapeutic drugs. Levetiracetam is recommended by many authors as first-line therapy in brain tumor-related epilepsy. Due to the possibility of interactions, the combination of enzyme-inducing AEDs and chemotherapeutic drugs, is usually not recommended as a first choice. Currently there is no evidence that prophylactic prescription of long-term AEDs in brain tumor-patients who did not present with seizures is justified. Because of the high risk of recurrence, however, AED treatment should be strongly considered after a single brain tumor-related seizure. The decision to withdraw AEDs must carefully consider the risk of seizure recurrence.ConclusionAt present levetiracetam is the preferred drug in brain tumor-related epilepsy, especially when drug interactions need to be avoided. In the future we hope to acquire more targeted drugs against this disorder by uncovering its pathogenesis.

Anticonvulsant therapy in brain-tumor related epilepsy

Journal of Epileptology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Anticonvulsant therapy in brain-tumor related epilepsy"}

BackgroundThe lifetime risk of patients with brain tumors to have focal epileptic seizures is 10–100%; the risk depends on different histology. Specific...

Anticonvulsant therapy in brain-tumor related epilepsy

Published Online: Apr 06, 2016

Page range: 41 - 56

Received: Feb 06, 2016

Accepted: Mar 29, 2016

DOI: https://doi.org/10.21307/joepi-2016-0004

Keywords
brain-tumor, epilepsy, antiepileptic drugs, chemiotherapeutic drugs, pharmacokinetic interactions

© 2016 Matti Sillanpää et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Anticonvulsant therapy in brain-tumor related epilepsy

Published Online: Apr 06, 2016

Page range: 41 - 56

Received: Feb 06, 2016

Accepted: Mar 29, 2016

DOI: https://doi.org/10.21307/joepi-2016-0004

Keywordsbrain-tumor, epilepsy, antiepileptic drugs, chemiotherapeutic drugs, pharmacokinetic interactions

© 2016 Matti Sillanpää et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
brain-tumor, epilepsy, antiepileptic drugs, chemiotherapeutic drugs, pharmacokinetic interactions