title: [Gliomas: fighting until the end against epilepsy; administration of antiepileptic drugs in the end-of-life phase].
abstract: In patients with high-grade glioma seizures occur relatively frequently during the end-of-life phase. At some point, the use of oral anti-epileptic drugs is no longer possible due to swallowing difficulties caused by advanced tumour progression. We have established a draft guideline and propose that anti-epileptic drugs be prescribed by alternative routes of administration in the end-of-life phase in glioma patients with known epilepsy who develop swallowing difficulties. Buccal clonazepam would be our drug of first choice as a maintenance treatment in addition to intranasal midazolam for the acute management of seizures. Adequate treatment of epileptic seizures, particularly during the end-of-life phase, can help to maintain quality of life as long as possible in patients with high-grade glioma.
authors.affiliation: VU medisch centrum, afd. Neurologie, Amsterdam.
authors.forename: Johan A F
authors.initials: JA
authors.lastname: Koekkoek
authors.forename: Manon S A
authors.initials: MS
authors.lastname: Boddaert
authors.forename: Martin  J B
authors.initials: M
authors.lastname: Taphoorn
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002998:Clonazepam / Q000008:administration & dosage / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy* / Q000209:etiology*; D005910:Glioma / Q000150:complications*; D006801:Humans; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use; D012640:Seizures / Q000188:drug therapy / Q000209:etiology; D013727:Terminal Care
chemical_list: D000927:Anticonvulsants; D002998:Clonazepam; D008874:Midazolam