Antiseizure medication for brain metastasis-related epilepsy: Findings of optimal choice from a retrospective cohort

Epilepsy Res. 2021 Dec:178:106812. doi: 10.1016/j.eplepsyres.2021.106812. Epub 2021 Nov 19.

Abstract

Objective: To analyze the prevalence of antiseizure medication (ASM) in patients with brain metastasis-related epilepsy (BMRE) treated with radiosurgery and the relationship between ASM and psychiatric comorbidity.

Material and methods: This is a cross-sectional observational design study with retrospective review of medical records of all patients with brain metastases treated with volumetric modulated arc therapy radiosurgery (VMAT-RS) between 2012 and 2018 in a tertiary oncology center. We included those patients with BMRE, analyzing the clinical and demographic data, with special attention to psychiatric comorbidities and the use of ASM.

Results: Of the 121 patients with brain metastases included for treatment with VMAT-RS, a total of 38 presented BMRE. The most widely used ASM as first-line treatment was levetiracetam (89%). Only 8% of the patients received sodium channel blockers. The most common psychiatric comorbidity was depression (42.1%).

Conclusions: Levetiracetam is the most widely used ASM in patients with BMRE treated with VMAT-RS. Nevertheless, common psychiatric comorbidities in this population might change the decision-making of ASM choice.

Keywords: Antiepileptic drug; Brain metastases; Mood disorder; Seizure; Sodium channel blockers; VMAT radiosurgery.

Publication types

  • Observational Study

MeSH terms

  • Anticonvulsants / therapeutic use
  • Brain Neoplasms* / complications
  • Brain Neoplasms* / drug therapy
  • Cross-Sectional Studies
  • Epilepsy* / drug therapy
  • Epilepsy* / epidemiology
  • Humans
  • Retrospective Studies

Substances

  • Anticonvulsants