Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Prophylactic Anticonvulsants in the Treatment of Adults with Metastatic Brain Tumors

Neurosurgery. 2019 Mar 1;84(3):E195-E197. doi: 10.1093/neuros/nyy545.

Abstract

Target populations: Adults with solid brain metastases who have not experienced a seizure.

Question 1: Do prophylactic antiepileptic drugs (AEDs) decrease the risk of seizures in nonsurgical patients with brain metastases who are otherwise seizure-free?

Recommendation: Level 3: Prophylactic AEDs are not recommended for patients with brain metastases who did not undergo surgical resection and are otherwise seizure-free.

Question 2: Do prophylactic AEDs decrease the risk of seizures in patients with brain metastases and no prior history of seizures in the postoperative setting?

Recommendation: Level 3: Routine postcraniotomy AED use for seizure-free patients with brain metastases is not recommended.The full guideline can be found at: https://www.cns.org/guidelines/guidelines-treatment-adults-metastatic-brain-tumors/chapter_8.

Keywords: Antiepileptic drugs; Cerebral metastases; Craniotomy; Seizure.

MeSH terms

  • Adult
  • Anticonvulsants / administration & dosage
  • Brain Neoplasms* / diagnosis
  • Brain Neoplasms* / secondary
  • Brain Neoplasms* / surgery
  • Congresses as Topic / standards
  • Craniotomy / adverse effects
  • Craniotomy / methods
  • Humans
  • Neurosurgeons* / standards
  • Post-Exposure Prophylaxis* / methods
  • Post-Exposure Prophylaxis* / standards
  • Practice Guidelines as Topic / standards
  • Seizures* / diagnosis
  • Seizures* / prevention & control
  • Systematic Reviews as Topic
  • Treatment Outcome

Substances

  • Anticonvulsants