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


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.
Wick
Wolfgang
W
Abteilung für Allgemeine Neurologie, Hertie-Institut für Klinische Hirnforschung, Zentrum für Neurologie, Universitatsklinikum Tübingen, Germany. wolfgang.wick@uni-tuebingen.de
Menn
Oliver
O
Meisner
Christoph
C
Steinbach
Joachim
J
Hermisson
Mirjam
M
Tatagiba
Marcos
M
Weller
Michael
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D002540:Cerebral Cortex / Q000187:drug effects / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D004347:Drug Interactions; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005910:Glioma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies
D000927:Anticonvulsants; D000970:Antineoplastic Agents