Gabapentin to control seizures in children undergoing cancer treatment.
Hepatic clearance of chemotherapy drugs is increased by many antiepilepsy drugs. At our institution, new-onset seizures in children on chemotherapy are treated with gabapentin, a nonhepatic enzyme inducer. The charts of all children given gabapentin for seizures were reviewed. At a median follow-up of 34 months, seizures were controlled in 74% of 50 children given gabapentin monotherapy as initial treatment: 91% of the leukemia group, 57% of the brain tumor group, and 75% of the other tumor group. Seizures were controlled in 49% of 59 children in whom gabapentin was added to other antiepilepsy drugs: 43% of the leukemia group, 53% of the brain tumor group, and 50% of the other tumor group. More than one seizure at presentation, focal neurologic deficits, high-dose methotrexate, brain irradiation, and T2-weighted signal abnormality around the brain tumor cavity predicted uncontrolled seizures. Only 8 children (7%) reported adverse effects, and the drug was discontinued in two. Gabapentin effectively controls seizures in children receiving chemotherapy and is well tolerated.
Khan
Raja B
RB
Division of Neuro-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA. raja.khan@stjude.org
Hunt
Daniel L
DL
Thompson
Stephen J
SJ
D000085:Acetates / Q000008:administration & dosage / Q000627:therapeutic use*; D000588:Amines; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001921:Brain / Q000503:physiopathology; D002648:Child; D003509:Cyclohexanecarboxylic Acids; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D000077206:Gabapentin; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects*; D012640:Seizures / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D012720:Severity of Illness Index; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D000970:Antineoplastic Agents; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin