The benefits and risks of prophylactic use of antiepileptic drug therapy in patients with brain tumor-related epilepsy_Journal of Epilepsy

Authors：

 YANGHu ^1,2 ,  CHENYangmei ¹

1. Department Of Neurology, the Second Affiliated Hospital Of Chongqing Medical University, Chongqing 400010, China;
2. Department Of Neurology, the First People's Hospital Of Chengdu, Chengdu, 610041;

Corresponding author：

CHENYangmei, Email: chenym1997@sina.com

Keywords：

Brain tumor; Antiepileptic drugs; Preventive treatment; Adverse reactions

DOI：

10.7507/2096-0247.20160056

Video：

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Objective Analysis prophylactic anti-epileptic drugs (AEDs) therapy in patients with brain tumor-related epilepsy (BTE) to observe whether seizures occurance, frequency will decrease, and the adverse reactions risk assessment of the patient's after using AEDs in 3 months and 12 month. Methods Retrospective analysis of the cases and follow-up data of patients with the diagnosis of brain tumors in the Second Affiliated Hospital of Chongqing Medical University in June 2011 to February 2015. Through the strict inclusion criteria and exclusion criteria review, the sixty-eight standard patients were divided into two groups:treatment group (44 cases) and control group (24 cases), and compared in the incidence of epilepsy and seizure frequency two groups of patients, and observe the adverse reactions after using AEDs. And analyzed the outcome of patients with brain tumors at 3 months and 2 months. Results Through at least 1 year follow up, compared the data of patients in the two groups with seizure incidence at 3 months and with seizures frequency≥3 times at 12 months, the difference was statistically significant (P < 0.05).In the treatment group, however, 7 patients experienced mild adverse reactions, such as dizziness, fatigue, nausea and vomiting, mild white blood cell reduction, mild liver damage, menstrual cycle changes, mental and behavioral abnormalities, etc.A patient discontinued due to mental disorder, and a patient change AEDs due to menstrual cycle change. All patients had no serious adverse reactions. Conclusions ①prophylactic use of AEDs can significantly reduce the incidence of seizures at 3 months; ②Although prophylactic use of AEDs did not reduce the incidence of seizures at 12 months, but can reduce the frequency of seizures; ③The risk of adverse reactions of prophylactic use of AEDs in patients with BTE is relatively low.

Citation： YANGHu, CHENYangmei. The benefits and risks of prophylactic use of antiepileptic drug therapy in patients with brain tumor-related epilepsy. Journal of Epilepsy, 2016, 2(4): 318-321. doi: 10.7507/2096-0247.20160056 Copy

1.	Vecht CJ, Kerkhof M, Duran-Pena A. Seizure prognosis in brain tumors:New insights and evidence-based management. Oncologist, 2014, 19(7):751-759.
2.	Van Breemen MS, Wilms EB, Vecht CJ. Seizure control in brain tumors. Handb Clin Neurol, 2012, 104(5):381-389.
3.	Vecht CJ, van Breemen M. Optimizing therapy of seizures in patients with brain tumors. Neurology, 2006, 67(12):10-13.
4.	Bar-Klein G, Cacheaux LP, Kamintsky L, et al. Losartan preventsacquired epilepsy via TGF-β signaling suppression. Ann Neurol, 2014, 75(6):864-875.
5.	Xiangyi Kong, Jian Guan, Yi Yang, et al. A meta-analysis:Do prophylactic antiepileptic drugs in patients withbrain tumors decrease the incidence of seizures?. Clinical Neurology and Neurosurgery, 2015, 134(11):98-103.
6.	Glauser T, Ben-Menachem E, Bourgeois Beta. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia, 2013, 54(4):551-563.
7.	Koubeissi M. Do we need seizure prophylaxis for brain tumor surgery?. Epilepsy Curr, 2014, 14(1):24-25.
8.	Brogna C, Gil S, Duffau H. Brain tumors and epilepsy. Expert Rev Neurother, 2008, 8(6):941-955.
9.	Luyken C, Blümcke I, Fimmers R, et al. The spectrum of long-term epilepsy-associated tumors:long-term seizure and tumor outcome and neurosurgical aspects.Epilepsia, 2003, 44(8):822-830.
10.	Brahimaj B, Greiner HM, Leach JL, et al. The surgical management of pediatric brain tumors causing epilepsy:consideration of the epileptogenic zone. Childs Nerv Syst, 2014, 30(7):1383-1391.
11.	Tremont-Lukats IW, Ratilal BO, Armstrong T, et al. Antiepileptic drugs for preventing seizures in people with brain tumors. Cochrane Database Syst Rev, 2008, 284(2):D4424.
12.	Bateman DE, Hardy JA, McDermott JR, et al. Amino acid neurotransmitter levels in gliomas and their relationship to the incidence of epilepsy. Neurol Res, 1988, 10(8):112-114.
13.	Schaller B, Ruegg SJ. Brain tumor and seizures:pathophysiology and its implications for treatment revisited. Epilepsia, 2003, 44(9):1223-1232.
14.	De Oliveira JA, Santana IA, Caires IQ, et al. Antiepileptic drug prophylaxis in primary brain tumor patients:is current practice in agreement to the consensus?. J Neurooncol, 2014, 120(2):399-403.
15.	Yuan Y, Peizhi Z, Maling G. The efficacy of levetiracetam for patients with supratentorial brain tumors. J Clin Neurosci, 2015, 22(2):1227-1231.
16.	Hossmann KA, Seo K, Szymas J, et al. Quantitativeanalysis of experimental peritumoral edema in cats. Adv Neurol, 1990, 52(10):449-458.
17.	Tinchon A, Oberndorfer S, Marosi C, et al. Haematological toxicity of valproic acid compared to levetiracetam in patients with glioblastoma multiforme undergoing concomitant radio-chemotherapy:a retrospective cohort study. J Neurol, 2015, 262(8):179-186.
18.	Fonkem E, Bricker P, Mungall D, et al. The role of levetiracetam in treatment of seizures in brain tumor patients. Front Neurol, 2013, 4(2):153.

1. Vecht CJ, Kerkhof M, Duran-Pena A. Seizure prognosis in brain tumors:New insights and evidence-based management. Oncologist, 2014, 19(7):751-759.
2. Van Breemen MS, Wilms EB, Vecht CJ. Seizure control in brain tumors. Handb Clin Neurol, 2012, 104(5):381-389.
3. Vecht CJ, van Breemen M. Optimizing therapy of seizures in patients with brain tumors. Neurology, 2006, 67(12):10-13.
4. Bar-Klein G, Cacheaux LP, Kamintsky L, et al. Losartan preventsacquired epilepsy via TGF-β signaling suppression. Ann Neurol, 2014, 75(6):864-875.
5. Xiangyi Kong, Jian Guan, Yi Yang, et al. A meta-analysis:Do prophylactic antiepileptic drugs in patients withbrain tumors decrease the incidence of seizures?. Clinical Neurology and Neurosurgery, 2015, 134(11):98-103.
6. Glauser T, Ben-Menachem E, Bourgeois Beta. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia, 2013, 54(4):551-563.
7. Koubeissi M. Do we need seizure prophylaxis for brain tumor surgery?. Epilepsy Curr, 2014, 14(1):24-25.
8. Brogna C, Gil S, Duffau H. Brain tumors and epilepsy. Expert Rev Neurother, 2008, 8(6):941-955.
9. Luyken C, Blümcke I, Fimmers R, et al. The spectrum of long-term epilepsy-associated tumors:long-term seizure and tumor outcome and neurosurgical aspects.Epilepsia, 2003, 44(8):822-830.
10. Brahimaj B, Greiner HM, Leach JL, et al. The surgical management of pediatric brain tumors causing epilepsy:consideration of the epileptogenic zone. Childs Nerv Syst, 2014, 30(7):1383-1391.
11. Tremont-Lukats IW, Ratilal BO, Armstrong T, et al. Antiepileptic drugs for preventing seizures in people with brain tumors. Cochrane Database Syst Rev, 2008, 284(2):D4424.
12. Bateman DE, Hardy JA, McDermott JR, et al. Amino acid neurotransmitter levels in gliomas and their relationship to the incidence of epilepsy. Neurol Res, 1988, 10(8):112-114.
13. Schaller B, Ruegg SJ. Brain tumor and seizures:pathophysiology and its implications for treatment revisited. Epilepsia, 2003, 44(9):1223-1232.
14. De Oliveira JA, Santana IA, Caires IQ, et al. Antiepileptic drug prophylaxis in primary brain tumor patients:is current practice in agreement to the consensus?. J Neurooncol, 2014, 120(2):399-403.
15. Yuan Y, Peizhi Z, Maling G. The efficacy of levetiracetam for patients with supratentorial brain tumors. J Clin Neurosci, 2015, 22(2):1227-1231.
16. Hossmann KA, Seo K, Szymas J, et al. Quantitativeanalysis of experimental peritumoral edema in cats. Adv Neurol, 1990, 52(10):449-458.
17. Tinchon A, Oberndorfer S, Marosi C, et al. Haematological toxicity of valproic acid compared to levetiracetam in patients with glioblastoma multiforme undergoing concomitant radio-chemotherapy:a retrospective cohort study. J Neurol, 2015, 262(8):179-186.
18. Fonkem E, Bricker P, Mungall D, et al. The role of levetiracetam in treatment of seizures in brain tumor patients. Front Neurol, 2013, 4(2):153.

Journal of Epilepsy

The benefits and risks of prophylactic use of antiepileptic drug therapy in patients with brain tumor-related epilepsy

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