Pharmacotherapy of epileptic seizures in glioma patients: who, when, why and how long?

Onkologie. 2005 Aug;28(8-9):391-6. doi: 10.1159/000086375. Epub 2005 Aug 29.

Abstract

Background: The risk for patients with primary brain tumors of experiencing an epileptic seizure at least once in the course of disease probably exceeds 50%, depending on tumor location and tumor type. Several aspects regarding the role of anticonvulsants in the treatment of brain tumor patients have remained controversial.

Patients and methods: We reviewed the seizure history in 107 patients undergoing a surgical procedure for glioma at our institution.

Results: The overall seizure incidence was 68%. Pre-operative seizures did not predict the occurrence of post-operative seizures. After surgery, postoperative chemo- or radiotherapy and anticonvulsive therapy one third of patients was seizure-free whereas one third showed frequent seizures despite this treatment. Seizure frequency increased regardless of anticonvulsive treatment with progressive or recurrent tumor growth.

Conclusions: Based on a literature review and our institutional experience, we delineate some recommendations for the management of seizures in patients with brain tumors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anticonvulsants / administration & dosage*
  • Anticonvulsants / adverse effects
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Brain Neoplasms / complications*
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / surgery
  • Cerebral Cortex* / drug effects
  • Cerebral Cortex* / surgery
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Disease Progression
  • Drug Interactions
  • Epilepsies, Partial / drug therapy*
  • Epilepsies, Partial / etiology
  • Female
  • Glioma / complications*
  • Glioma / diagnosis
  • Glioma / drug therapy
  • Glioma / surgery
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / complications
  • Neoplasm Recurrence, Local / diagnosis
  • Retrospective Studies

Substances

  • Anticonvulsants
  • Antineoplastic Agents