The role of prophylactic anticonvulsants in the management of brain metastases: a systematic review and evidence-based clinical practice guideline.
OBJECTIVE
Do prophylactic anticonvulsants decrease the risk of seizure in patients with metastatic brain tumors compared with no treatment?


METHODS
These recommendations apply to adults with solid brain metastases who have not experienced a seizure due to their metastatic brain disease.


CONCLUSIONS
Level 3 For adults with brain metastases who have not experienced a seizure due to their metastatic brain disease, routine prophylactic use of anticonvulsants is not recommended. Only a single underpowered randomized controlled trial (RCT), which did not detect a difference in seizure occurrence, provides evidence for decision-making purposes.
Mikkelsen
Tom
T
Department of Neurology, Henry Ford Health System, Detroit, MI, USA.
Paleologos
Nina A
NA
Robinson
Paula D
PD
Ammirati
Mario
M
Andrews
David W
DW
Asher
Anthony L
AL
Burri
Stuart H
SH
Cobbs
Charles S
CS
Gaspar
Laurie E
LE
Kondziolka
Douglas
D
Linskey
Mark E
ME
Loeffler
Jay S
JS
McDermott
Michael
M
Mehta
Minesh P
MP
Olson
Jeffrey J
JJ
Patchell
Roy A
RA
Ryken
Timothy C
TC
Kalkanis
Steven N
SN
D000925:Anticoagulants / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000150:complications* / Q000556:secondary; D016208:Databases, Factual / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology* / Q000517:prevention & control*
D000925:Anticoagulants