Epilepsy in primary brain tumors: Practical aspects of diagnosis and management

R. Michelucci, P. Riguzzi, L. Volpi, S. Testoni, G. Rubboli

Research output: Contribution to journalArticlepeer-review

Abstract

Seizures are a frequent symptom of brain tumors and their incidence largely depends on the tumor subtype and location. The risk for development of seizures in supratentorial brain tumor patients is higher in slow-growing tumors than in malignant and aggressive gliomas. Moreover tumors localized in the primary sensory-motor cortex are more prone to present with seizures. The use of antiepileptic drugs (AEDs) in the treatment of epilepsies caused by brain tumors is standard but a significant proportion of patients are refractory to conventional treatment. The overexpression of multidrug resistance proteins is considered an interesting hypothesis to explain resistance to AEDs. From analysis of the current literature it is clear that AEDs should also be prescribed on a short-term basis to prevent seizures occurring within the first week following surgery for brain tumors. In contrast, long-term treatment to avoid first seizures in patients with primary or secondary cerebral neoplasms has no rational basis. It is reasonable, however, that new AEDs showing antiepileptogenic properties in animal models should be tested in well-designed prophylaxis clinical trials. Some of the new AEDs have a specific favourable safety and pharmacokinetic profile. These characteristics are particularly important in the population with cerebral tumors in order to avoid interactions with chemotherapeutic agents, severe cutaneous reactions during radiotherapy, or confounding CNS-related side-effects that mask the symptoms of the underlying pathology.

Original languageEnglish
Pages (from-to)201-207
Number of pages7
JournalRivista Medica
Volume13
Issue number4
Publication statusPublished - Dec 2007

Keywords

  • Antiepileptic drugs
  • Cerebral tumor
  • Epilepsy
  • Radiotherapy

ASJC Scopus subject areas

  • Medicine(all)

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