Management of epilepsy in oncological patients.
BACKGROUND
Comorbidity between epilepsy and cancer is elevated. As a life-time condition, it is not impossible for a patient with epilepsy to have a cancer at some point. Besides, at least 30% of patients with primary brain tumors have epileptic seizures, but also in patients with metastatic infiltrating lesions of the central nervous system and with extracerebral tumors, epilepsy can be related. Seizures may also appear associated with paraneoplastic syndromes, such as limbic encephalitis and metabolic and infectious complications of chemotherapy and radiotherapy.


RESULTS
The precise mechanisms by which brain tumors and the other conditions mentioned above produce seizures are not fully understood, but are reviewed in this article, as well as the many different therapeutic options that may be used in the treatment of epileptic seizures. Pharmacological treatment poses various controversies, such as the utility of prophylactic treatment, interactions between antiepileptic drugs (AEDs) and chemotherapeutic drugs and the complications derived from the adverse effects of AEDs in this population. Finally, other treatments are proposed such as chemotherapy, radiotherapy and surgery, the rational application of which allows for an improvement in the patients' quality of life.


CONCLUSIONS
In order to arrive at a diagnosis, the different causes that could condition the appearance of epileptic seizures in cancer patients must be known. After this, the most adequate treatment should be chosen, thus ensuring the comprehensive treatment of cancer and epilepsy.
Villanueva
Vicente
V
Epilepsy Unit, Neurology Department, Hospital La Fe, Valencia, Spain. vevillanuevah@yahoo.es
Codina
Montserrat
M
Elices
Eloy
E
D000927:Anticonvulsants / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000145:classification / Q000150:complications / Q000628:therapy*; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D006801:Humans
D000927:Anticonvulsants