Management of epilepsy in brain tumors

Brain Tumor-related Epilepsy study group of Italian League Against Epilepsy (LICE); Marta Maschio; Umberto Aguglia; Giuliano Avanzini; Paola Banfi; Carla Buttinelli; Giuseppe Capovilla; Marina Maria Luisa Casazza; Gabriella Colicchio; Antonietta Coppola; Cinzia Costa; Filippo Dainese; Ornella Daniele; Roberto De Simone; Marica Eoli; Sara Gasparini; Anna Teresa Giallonardo; Angela La Neve; Andrea Maialetti; Oriano Mecarelli; Marta Melis; Roberto Michelucci; Francesco Paladin; Giada Pauletto; Marta Piccioli; Stefano Quadri; Federica Ranzato; Rosario Rossi; Andrea Salmaggi; Riccardo Terenzi; Paolo Tisei; Flavio Villani; Paolo Vitali; Lucina Carla Vivalda; Gaetano Zaccara; Alessia Zarabla; Ettore Beghi

doi:10.1007/s10072-019-04025-9

Management of epilepsy in brain tumors

Brain Tumor-related Epilepsy study group of Italian League Against Epilepsy (LICE), Marta Maschio, Umberto Aguglia, Giuliano Avanzini, Paola Banfi, Carla Buttinelli, Giuseppe Capovilla, Marina Maria Luisa Casazza, Gabriella Colicchio, Antonietta Coppola, Cinzia Costa, Filippo Dainese, Ornella Daniele, Roberto De Simone, Marica Eoli, Sara Gasparini, Anna Teresa Giallonardo, Angela La Neve, Andrea Maialetti, Oriano MecarelliMarta Melis, Roberto Michelucci, Francesco Paladin, Giada Pauletto, Marta Piccioli, Stefano Quadri, Federica Ranzato, Rosario Rossi, Andrea Salmaggi, Riccardo Terenzi, Paolo Tisei, Flavio Villani, Paolo Vitali, Lucina Carla Vivalda, Gaetano Zaccara, Alessia Zarabla, Ettore Beghi

Research output: Contribution to journal › Article

Abstract

Epilepsy in brain tumors (BTE) may require medical attention for a variety of unique concerns: epileptic seizures, possible serious adverse effects of antineoplastic and antiepileptic drugs (AEDs), physical disability, and/or neurocognitive disturbances correlated to tumor site. Guidelines for the management of tumor-related epilepsies are lacking. Treatment is not standardized, and overall management might differ according to different specialists. The aim of this document was to provide directives on the procedures to be adopted for a correct diagnostic-therapeutic path of the patient with BTE, evaluating indications, risks, and benefits. A board comprising neurologists, epileptologists, neurophysiologists, neuroradiologists, neurosurgeons, neuro-oncologists, neuropsychologists, and patients' representatives was formed. The board converted diagnostic and therapeutic problems into seventeen questions. A literature search was performed in September-October 2017, and a total of 7827 unique records were retrieved, of which 148 constituted the core literature. There is no evidence that histological type or localization of the brain tumor affects the response to an AED. The board recommended to avoid enzyme-inducing antiepileptic drugs because of their interference with antitumoral drugs and consider as first-choice newer generation drugs (among them, levetiracetam, lamotrigine, and topiramate). Valproic acid should also be considered. Both short-term and long-term prophylaxes are not recommended in primary and metastatic brain tumors. Management of seizures in patients with BTE should be multidisciplinary. The panel evidenced conflicting or lacking data regarding the role of EEG, the choice of therapeutic strategy, and timing to withdraw AEDs and recommended high-quality long-term studies to standardize BTE care.

Original language	Italian
Pages (from-to)	2217-2234
Journal	Neurol. Sci.
Volume	40
DOIs	https://doi.org/10.1007/s10072-019-04025-9
Publication status	Published - Aug 7 2019

Access to Document

10.1007/s10072-019-04025-9

Cite this

(LICE), B. T. E. S. G. O. I. L. A. E., Maschio, M., Aguglia, U., Avanzini, G., Banfi, P., Buttinelli, C., Capovilla, G., Casazza, M. M. L., Colicchio, G., Coppola, A., Costa, C., Dainese, F., Daniele, O., De Simone, R., Eoli, M., Gasparini, S., Giallonardo, A. T., La Neve, A., Maialetti, A., ... Beghi, E. (2019). Management of epilepsy in brain tumors. Neurol. Sci., 40, 2217-2234. https://doi.org/10.1007/s10072-019-04025-9

Management of epilepsy in brain tumors. / (LICE), Brain Tumor-related Epilepsy study group of Italian League Against Epilepsy; Maschio, Marta; Aguglia, Umberto; Avanzini, Giuliano; Banfi, Paola; Buttinelli, Carla; Capovilla, Giuseppe; Casazza, Marina Maria Luisa; Colicchio, Gabriella; Coppola, Antonietta; Costa, Cinzia; Dainese, Filippo; Daniele, Ornella; De Simone, Roberto; Eoli, Marica; Gasparini, Sara; Giallonardo, Anna Teresa; La Neve, Angela; Maialetti, Andrea; Mecarelli, Oriano; Melis, Marta; Michelucci, Roberto; Paladin, Francesco; Pauletto, Giada; Piccioli, Marta; Quadri, Stefano; Ranzato, Federica; Rossi, Rosario; Salmaggi, Andrea; Terenzi, Riccardo; Tisei, Paolo; Villani, Flavio ; Vitali, Paolo; Vivalda, Lucina Carla; Zaccara, Gaetano; Zarabla, Alessia ; Beghi, Ettore.

In: Neurol. Sci., Vol. 40, 07.08.2019, p. 2217-2234.

Research output: Contribution to journal › Article

(LICE), BTESGOILAE, Maschio, M, Aguglia, U, Avanzini, G, Banfi, P, Buttinelli, C, Capovilla, G, Casazza, MML, Colicchio, G, Coppola, A, Costa, C, Dainese, F, Daniele, O, De Simone, R, Eoli, M, Gasparini, S, Giallonardo, AT, La Neve, A, Maialetti, A, Mecarelli, O, Melis, M, Michelucci, R, Paladin, F, Pauletto, G, Piccioli, M, Quadri, S, Ranzato, F, Rossi, R, Salmaggi, A, Terenzi, R, Tisei, P, Villani, F , Vitali, P, Vivalda, LC, Zaccara, G, Zarabla, A & Beghi, E 2019, 'Management of epilepsy in brain tumors', Neurol. Sci., vol. 40, pp. 2217-2234. https://doi.org/10.1007/s10072-019-04025-9

(LICE), Brain Tumor-related Epilepsy study group of Italian League Against Epilepsy ; Maschio, Marta ; Aguglia, Umberto ; Avanzini, Giuliano ; Banfi, Paola ; Buttinelli, Carla ; Capovilla, Giuseppe ; Casazza, Marina Maria Luisa ; Colicchio, Gabriella ; Coppola, Antonietta ; Costa, Cinzia ; Dainese, Filippo ; Daniele, Ornella ; De Simone, Roberto ; Eoli, Marica ; Gasparini, Sara ; Giallonardo, Anna Teresa ; La Neve, Angela ; Maialetti, Andrea ; Mecarelli, Oriano ; Melis, Marta ; Michelucci, Roberto ; Paladin, Francesco ; Pauletto, Giada ; Piccioli, Marta ; Quadri, Stefano ; Ranzato, Federica ; Rossi, Rosario ; Salmaggi, Andrea ; Terenzi, Riccardo ; Tisei, Paolo ; Villani, Flavio ; Vitali, Paolo ; Vivalda, Lucina Carla ; Zaccara, Gaetano ; Zarabla, Alessia ; Beghi, Ettore. / Management of epilepsy in brain tumors. In: Neurol. Sci. 2019 ; Vol. 40. pp. 2217-2234.

@article{5bcfa405fad847f5b4ba9b5b43f2e12e,

title = "Management of epilepsy in brain tumors",

abstract = "Epilepsy in brain tumors (BTE) may require medical attention for a variety of unique concerns: epileptic seizures, possible serious adverse effects of antineoplastic and antiepileptic drugs (AEDs), physical disability, and/or neurocognitive disturbances correlated to tumor site. Guidelines for the management of tumor-related epilepsies are lacking. Treatment is not standardized, and overall management might differ according to different specialists. The aim of this document was to provide directives on the procedures to be adopted for a correct diagnostic-therapeutic path of the patient with BTE, evaluating indications, risks, and benefits. A board comprising neurologists, epileptologists, neurophysiologists, neuroradiologists, neurosurgeons, neuro-oncologists, neuropsychologists, and patients' representatives was formed. The board converted diagnostic and therapeutic problems into seventeen questions. A literature search was performed in September-October 2017, and a total of 7827 unique records were retrieved, of which 148 constituted the core literature. There is no evidence that histological type or localization of the brain tumor affects the response to an AED. The board recommended to avoid enzyme-inducing antiepileptic drugs because of their interference with antitumoral drugs and consider as first-choice newer generation drugs (among them, levetiracetam, lamotrigine, and topiramate). Valproic acid should also be considered. Both short-term and long-term prophylaxes are not recommended in primary and metastatic brain tumors. Management of seizures in patients with BTE should be multidisciplinary. The panel evidenced conflicting or lacking data regarding the role of EEG, the choice of therapeutic strategy, and timing to withdraw AEDs and recommended high-quality long-term studies to standardize BTE care.",

author = "(LICE), {Brain Tumor-related Epilepsy study group of Italian League Against Epilepsy} and Marta Maschio and Umberto Aguglia and Giuliano Avanzini and Paola Banfi and Carla Buttinelli and Giuseppe Capovilla and Casazza, {Marina Maria Luisa} and Gabriella Colicchio and Antonietta Coppola and Cinzia Costa and Filippo Dainese and Ornella Daniele and {De Simone}, Roberto and Marica Eoli and Sara Gasparini and Giallonardo, {Anna Teresa} and {La Neve}, Angela and Andrea Maialetti and Oriano Mecarelli and Marta Melis and Roberto Michelucci and Francesco Paladin and Giada Pauletto and Marta Piccioli and Stefano Quadri and Federica Ranzato and Rosario Rossi and Andrea Salmaggi and Riccardo Terenzi and Paolo Tisei and Flavio Villani and Paolo Vitali and Vivalda, {Lucina Carla} and Gaetano Zaccara and Alessia Zarabla and Ettore Beghi",

year = "2019",

month = aug,

day = "7",

doi = "10.1007/s10072-019-04025-9",

language = "Italian",

volume = "40",

pages = "2217--2234",

journal = "Neurol. Sci.",

issn = "1590-1874",

publisher = "Springer-Verlag Italia s.r.l.",

}

TY - JOUR

T1 - Management of epilepsy in brain tumors

AU - (LICE), Brain Tumor-related Epilepsy study group of Italian League Against Epilepsy

AU - Maschio, Marta

AU - Aguglia, Umberto

AU - Avanzini, Giuliano

AU - Banfi, Paola

AU - Buttinelli, Carla

AU - Capovilla, Giuseppe

AU - Casazza, Marina Maria Luisa

AU - Colicchio, Gabriella

AU - Coppola, Antonietta

AU - Costa, Cinzia

AU - Dainese, Filippo

AU - Daniele, Ornella

AU - De Simone, Roberto

AU - Eoli, Marica

AU - Gasparini, Sara

AU - Giallonardo, Anna Teresa

AU - La Neve, Angela

AU - Maialetti, Andrea

AU - Mecarelli, Oriano

AU - Melis, Marta

AU - Michelucci, Roberto

AU - Paladin, Francesco

AU - Pauletto, Giada

AU - Piccioli, Marta

AU - Quadri, Stefano

AU - Ranzato, Federica

AU - Rossi, Rosario

AU - Salmaggi, Andrea

AU - Terenzi, Riccardo

AU - Tisei, Paolo

AU - Villani, Flavio

AU - Vitali, Paolo

AU - Vivalda, Lucina Carla

AU - Zaccara, Gaetano

AU - Zarabla, Alessia

AU - Beghi, Ettore

PY - 2019/8/7

Y1 - 2019/8/7

N2 - Epilepsy in brain tumors (BTE) may require medical attention for a variety of unique concerns: epileptic seizures, possible serious adverse effects of antineoplastic and antiepileptic drugs (AEDs), physical disability, and/or neurocognitive disturbances correlated to tumor site. Guidelines for the management of tumor-related epilepsies are lacking. Treatment is not standardized, and overall management might differ according to different specialists. The aim of this document was to provide directives on the procedures to be adopted for a correct diagnostic-therapeutic path of the patient with BTE, evaluating indications, risks, and benefits. A board comprising neurologists, epileptologists, neurophysiologists, neuroradiologists, neurosurgeons, neuro-oncologists, neuropsychologists, and patients' representatives was formed. The board converted diagnostic and therapeutic problems into seventeen questions. A literature search was performed in September-October 2017, and a total of 7827 unique records were retrieved, of which 148 constituted the core literature. There is no evidence that histological type or localization of the brain tumor affects the response to an AED. The board recommended to avoid enzyme-inducing antiepileptic drugs because of their interference with antitumoral drugs and consider as first-choice newer generation drugs (among them, levetiracetam, lamotrigine, and topiramate). Valproic acid should also be considered. Both short-term and long-term prophylaxes are not recommended in primary and metastatic brain tumors. Management of seizures in patients with BTE should be multidisciplinary. The panel evidenced conflicting or lacking data regarding the role of EEG, the choice of therapeutic strategy, and timing to withdraw AEDs and recommended high-quality long-term studies to standardize BTE care.

AB - Epilepsy in brain tumors (BTE) may require medical attention for a variety of unique concerns: epileptic seizures, possible serious adverse effects of antineoplastic and antiepileptic drugs (AEDs), physical disability, and/or neurocognitive disturbances correlated to tumor site. Guidelines for the management of tumor-related epilepsies are lacking. Treatment is not standardized, and overall management might differ according to different specialists. The aim of this document was to provide directives on the procedures to be adopted for a correct diagnostic-therapeutic path of the patient with BTE, evaluating indications, risks, and benefits. A board comprising neurologists, epileptologists, neurophysiologists, neuroradiologists, neurosurgeons, neuro-oncologists, neuropsychologists, and patients' representatives was formed. The board converted diagnostic and therapeutic problems into seventeen questions. A literature search was performed in September-October 2017, and a total of 7827 unique records were retrieved, of which 148 constituted the core literature. There is no evidence that histological type or localization of the brain tumor affects the response to an AED. The board recommended to avoid enzyme-inducing antiepileptic drugs because of their interference with antitumoral drugs and consider as first-choice newer generation drugs (among them, levetiracetam, lamotrigine, and topiramate). Valproic acid should also be considered. Both short-term and long-term prophylaxes are not recommended in primary and metastatic brain tumors. Management of seizures in patients with BTE should be multidisciplinary. The panel evidenced conflicting or lacking data regarding the role of EEG, the choice of therapeutic strategy, and timing to withdraw AEDs and recommended high-quality long-term studies to standardize BTE care.

U2 - 10.1007/s10072-019-04025-9

DO - 10.1007/s10072-019-04025-9

M3 - Articolo

VL - 40

SP - 2217

EP - 2234

JO - Neurol. Sci.

JF - Neurol. Sci.

SN - 1590-1874

ER -