Characterization of seizures (ILAE 1981 and 2017 classifications) and their response to treatment in a cohort of patients with glial tumors: A prospective single center study

Parera, Ignacio Casas; Roffo, María A. Gonzalez; Báez, Alejandra; Quintans, Fernando; Oropeza, Paola Castellanos; Retamar, María C. Sánchez

doi:10.1016/j.ensci.2018.12.006

Cited by 3 publications

(2 citation statements)

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“…Levetiracetam is frequently prescribed in BTRE patients, being one of the most widely used first-line ASM (Sánchez-Villalobos et al, 2021a). Numerous studies have shown the efficacy of levetiracetam in BTRE patients both in monotherapy (Dinapoli et al, 2009;Merrell et al, 2010;Rosati et al, 2010;Usery et al, 2010;Maschio et al, 2011b;De Groot et al, 2011;Bähr et al, 2012;Rossetti et al, 2014;Berntsson et al, 2018;Cardona et al, 2018;Casas Parera et al, 2019;Kerkhof et al, 2019;Ius et al, 2020;Solomons et al, 2020) and in polytherapy (Wagner et al, 2003;Maschio et al, 2006;Newton et al, 2006;Van Breemen et al, 2009;Haggiagi (Bonney et al, 2016), d (Englot et al, 2016a, e (You et al, 2012), f (Lee et al, 2010), g (Goldstein and Feyissa, 2018), h (Michelucci et al, 2013), i (Singh et al, 2020, j (Wolpert et al, 2020), k (Wirsching et al, 2016), l (Englot et al, 2016b), m (Fox et al, 2019).…”

Section: Levetiracetammentioning

confidence: 99%

“…Levetiracetam is frequently prescribed in BTRE patients, being one of the most widely used first-line ASM ( Sánchez-Villalobos et al, 2021a ). Numerous studies have shown the efficacy of levetiracetam in BTRE patients both in monotherapy ( Dinapoli et al, 2009 ; Merrell et al, 2010 ; Rosati et al, 2010 ; Usery et al, 2010 ; Maschio et al, 2011b ; De Groot et al, 2011 ; Bähr et al, 2012 ; Rossetti et al, 2014 ; Berntsson et al, 2018 ; Cardona et al, 2018 ; Casas Parera et al, 2019 ; Kerkhof et al, 2019 ; Ius et al, 2020 ; Solomons et al, 2020 ) and in polytherapy ( Wagner et al, 2003 ; Maschio et al, 2006 ; Newton et al, 2006 ; Van Breemen et al, 2009 ; Haggiagi and Avila, 2019 ; Chonan et al, 2020 ; Rudà et al, 2020 ). In a recent systematic review ( Bruin et al, 2021 ), patients with seizures secondary to grade II-IV gliomas treated with levetiracetam monotherapy had a 6-months seizure freedom rate of 39–96%, with a 6-months failure rate due to adverse effects and ineffectiveness of 1% and 10%, respectively.…”

Section: Antiseizure Medication For Brain Tumor-related Epilepsymentioning

confidence: 99%

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Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios

et al. 2022

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Epilepsy represents a challenge in the management of patients with brain tumors. Epileptic seizures are one of the most frequent comorbidities in neuro-oncology and may be the debut symptom of a brain tumor or a complication during its evolution. Epileptogenic mechanisms of brain tumors are not yet fully elucidated, although new factors related to the underlying pathophysiological process with possible treatment implications have been described. In recent years, the development of new anti-seizure medications (ASM), with better pharmacokinetic profiles and fewer side effects, has become a paradigm shift in many clinical scenarios in neuro-oncology, being able, for instance, to adapt epilepsy treatment to specific features of each patient. This is crucial in several situations, such as patients with cognitive/psychiatric comorbidity, pregnancy, or advanced age, among others. In this narrative review, we provide a rationale for decision-making in ASM choice for neuro-oncologic patients, highlighting the strengths and weaknesses of each drug. In addition, according to current literature evidence, we try to answer some of the most frequent questions that arise in daily clinical practice in patients with epilepsy related to brain tumors, such as, which patients are the best candidates for ASM and when to start it, what is the best treatment option for each patient, and what are the major pitfalls to be aware of during follow-up.

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Section: Levetiracetammentioning

confidence: 99%

“…Levetiracetam is frequently prescribed in BTRE patients, being one of the most widely used first-line ASM ( Sánchez-Villalobos et al, 2021a ). Numerous studies have shown the efficacy of levetiracetam in BTRE patients both in monotherapy ( Dinapoli et al, 2009 ; Merrell et al, 2010 ; Rosati et al, 2010 ; Usery et al, 2010 ; Maschio et al, 2011b ; De Groot et al, 2011 ; Bähr et al, 2012 ; Rossetti et al, 2014 ; Berntsson et al, 2018 ; Cardona et al, 2018 ; Casas Parera et al, 2019 ; Kerkhof et al, 2019 ; Ius et al, 2020 ; Solomons et al, 2020 ) and in polytherapy ( Wagner et al, 2003 ; Maschio et al, 2006 ; Newton et al, 2006 ; Van Breemen et al, 2009 ; Haggiagi and Avila, 2019 ; Chonan et al, 2020 ; Rudà et al, 2020 ). In a recent systematic review ( Bruin et al, 2021 ), patients with seizures secondary to grade II-IV gliomas treated with levetiracetam monotherapy had a 6-months seizure freedom rate of 39–96%, with a 6-months failure rate due to adverse effects and ineffectiveness of 1% and 10%, respectively.…”

Section: Antiseizure Medication For Brain Tumor-related Epilepsymentioning

confidence: 99%

Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios

et al. 2022

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Epilepsy and education: A case-control analysis of the impact of an intensive epilepsy training program on undergraduate medical students

Diaz-Peregrino,

San-Juan,

Arritola-Uriarte

et al. 2024

Epilepsy & Behavior

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Efficacy of antiepileptic drugs in glioma patients with epilepsy: a systematic review

Bruin

Meer

Dirven

et al. 2021

Neuro-Oncology Practice

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Background Comprehensive data on the efficacy and tolerability of AED treatment in glioma patients with epilepsy is currently lacking. In this systematic review we specifically assessed the efficacy of AEDs in patients with a grade II-IV glioma. Methods Electronic databases PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane library were searched up to June 2020. Three different outcomes for both mono- and polytherapy were extracted from all eligible articles: (I) seizure freedom; (II) ≥50% reduction in seizure frequency; and (III) treatment failure. Weighted averages (WA) were calculated for outcomes at 6 and 12 months. Results A total of 66 studies were included. Regarding the individual outcomes on the efficacy of monotherapy, the highest seizure freedom rate at 6 months was with phenytoin (WA=72%) while at 12 months pregabalin (WA=75%) and levetiracetam (WA=74%) showed highest efficacy. Concerning ≥50% seizure reduction rates, levetiracetam showed highest efficacy at 6 and 12 months (WAs of 82% and 97%, respectively). However, treatment failure rates at 12 months were highest for phenytoin (WA=34%) and pregabalin (41%). When comparing the described polytherapy combinations with follow-up of ≥6 months, levetiracetam combined with phenytoin was most effective followed by levetiracetam combined with valproic acid. Conclusion Given the heterogeneous patient populations and the low scientific quality across the different studies, seizure rates need to be interpreted with caution. Based on the current limited evidence, with the ranking of AEDs being confined to the AEDs studied, levetiracetam, phenytoin and pregabalin seem to be most effective as AED monotherapy in glioma patients with epilepsy, with levetiracetam showing the lowest treatment failure rate, compared to the other AEDs studied.

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Characterization of seizures (ILAE 1981 and 2017 classifications) and their response to treatment in a cohort of patients with glial tumors: A prospective single center study

Cited by 3 publications

References 31 publications

Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios

Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios

Epilepsy and education: A case-control analysis of the impact of an intensive epilepsy training program on undergraduate medical students

Efficacy of antiepileptic drugs in glioma patients with epilepsy: a systematic review

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