title: Intravenous and oral levetiracetam in patients with a suspected primary brain tumor and symptomatic seizures undergoing neurosurgery: the HELLO trial.
abstract: BACKGROUND
  Levetiracetam (LEV) is a newer anticonvulsant with a favorable safety profile. There seem to be no relevant drug interactions, and an intravenous formulation is available. Therefore, LEV might be a suitable drug for the perioperative anticonvulsive therapy of patients with suspected brain tumors undergoing neurosurgery.
  
  
  METHODS
  In this prospective study (NCT00571155) patients with suspected primary brain tumors and tumor-related seizures were perioperatively treated with oral and intravenous LEV up to 4 weeks before and until 4 weeks after a planned neurosurgical procedure.
  
  
  RESULTS
  Thirty patients with brain tumor-related seizures and intended neurosurgery were included. Three patients did not undergo the scheduled surgery after enrollment, and two patients were lost to follow-up. Therefore, 25 patients were fully evaluable. After initiation of therapy with LEV, 100% of the patients were seizure-free in the pre-surgery phase (3 days up to 4 weeks before surgery), 88% in the 48 h post-surgery phase and 84% in the early follow-up phase (48 h to 4 weeks post surgery). Treatment failure even after dose escalation to 3,000 mg/day occurred in three patients. No serious adverse events related to the treatment with LEV occurred.
  
  
  CONCLUSIONS
  Our data show the feasibility and safety of oral and intravenous LEV in the perioperative treatment of tumor-related seizures. Although this was a single arm study, the efficacy of LEV appears promising. Considering the side effects and interactions of other anticonvulsants, LEV seems to be a favorable option in the perioperative treatment of brain tumor-related seizures.
authors: Dr. Senckenberg Institute of Neurooncology, Johann Wolfgang Goethe University Frankfurt, Schleusenweg 2-16, 60528 Frankfurt, Germany. oliver.baehr@med.uni-frankfurt.de
authors: Oliver
authors: O
authors: Bähr
authors: Mirjam
authors: M
authors: Hermisson
authors: Sabine
authors: S
authors: Rona
authors: Johannes
authors: J
authors: Rieger
authors: Susanne
authors: S
authors: Nussbaum
authors: Peter
authors: P
authors: Körtvelyessy
authors: Kea
authors: K
authors: Franz
authors: Marcos
authors: M
authors: Tatagiba
authors: Volker
authors: V
authors: Seifert
authors: Michael
authors: M
authors: Weller
authors: Joachim P
authors: JP
authors: Steinbach
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D004569:Electroencephalography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007262:Infusions, Intravenous; D000077287:Levetiracetam; D008297:Male; D008579:Meningioma / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009493:Neurosurgery; D019635:Neurosurgical Procedures; D010865:Pilot Projects; D010889:Piracetam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011446:Prospective Studies; D012640:Seizures / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam