Efficacy of perioperative anticonvulsant prophylaxis in seizure-naïve glioma patients: A meta-analysis

Wang, Xiaomeng; Zheng, Xueping; Hu, Song; Xing, Ang; Wang, Zixuan; Song, Yan; Chen, Jingjiao; Tian, Sijia; Mao, Yongjun; Chi, Xiaosa

doi:10.1016/j.clineuro.2019.105529

Cited by 8 publications

(8 citation statements)

References 25 publications

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“…According to a recent meta-analysis, ASM prophylaxis does not reduce the incidence of postoperative seizure in seizure-naïve brain tumor patients. On the contrary, ASM prophylaxis is associated with a relatively high rate of dermatological (rash), neurological (ataxia, decreased level of consciousness and aphasia), psychiatric (depression), and hematological (thrombocytopenia, electrolyte imbalance) SEs (up to 17–34%) ( 20 ). Supporting this evidence, we have shown that psychiatric SEs of prophylactic therapy, which are generally underestimated, may occur in patients with a brain tumor.…”

Section: Discussionmentioning

confidence: 99%

Levetiracetam Prophylaxis Therapy for Brain Tumor-Related Epilepsy (BTRE) Is Associated With a Higher Psychiatric Burden

et al. 2022

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Purpose: Brain tumor-related epilepsy (BTRE) is a condition characterized by the development of seizures in the context of an undergoing oncological background. Levetiracetam (LEV) is a third-generation anti-seizure medication (ASM) widely used in BTRE prophylaxis. The study evaluated LEV neuropsychiatric side effects (SEs) in BTRE prophylaxis.Method: Twenty-eight patients with brain tumors were retrospectively selected and divided into two groups. In one group, we evaluated patients with a BTRE diagnosis using LEV (BTRE-group). The other group included patients with brain tumors who never had epilepsy and used a prophylactic ASM regimen with LEV (PROPHYLAXIS-group). Neuropsychiatric SEs of LEV were monitored using the Neuropsychiatric Inventory Questionnaire (NPI-Q) at the baseline visit and the 6- and 12-month follow-up.Results: Eighteen patients of the BTRE-group and 10 patients of the PROPHYLAXIS-group were included. Compared to the BTRE-group, the PROPHYLAXIS-group showed a higher severity of neuropsychiatric symptoms. According to Linear Mixed Models (LMM), a multiplicative effect was observed for the interaction between group treatment and time. For the caregiver distress score (CDS), only a time-effect was observed.Conclusion: Prophylactic ASM with LEV is associated with an increased frequency of neuropsychiatric SE. Accurate epileptological evaluations in patients with brain tumors are mandatory to select who would benefit most from ASM.

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Section: Discussionmentioning

confidence: 99%

Levetiracetam Prophylaxis Therapy for Brain Tumor-Related Epilepsy (BTRE) Is Associated With a Higher Psychiatric Burden

et al. 2022

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“…In several previous studies, the incidence of adverse events brought on by prophylactic AEDs was rather significant, reaching 34%. Significantly, serious side effects such as toxic epidermal necrolysis and lowered levels of consciousness were documented [ 24 25 26 ]. A decreased level of consciousness can be a major obstacle to rehabilitation treatment.…”

Section: Other Complicationsmentioning

confidence: 99%

Brain Tumor Rehabilitation: Symptoms, Complications, and Treatment Strategy

Park

2022

Brain Neurorehabil

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Brain tumors are receiving increasing attention in cancer rehabilitation due to their high rate of neurological deterioration. Motor dysfunction, cognitive deterioration, and emotional problems are commonly present in patients with brain tumors. Other medical complications, such as seizures, headache, and dysphagia are also common. An individualized multidisciplinary rehabilitation intervention is necessary to treat functional impairment due to the tumor itself and/or treatment-related dysfunction. Herein, we discuss rehabilitation treatment strategies in relation to the neurological and functional complications that commonly occur in patients with brain tumors.

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“…Even in patients with newly diagnosed brain tumors who have not yet had epileptic seizures, two randomized trials failed to demonstrate any benefit for primary prevention [17,22]. Thus, according to current recommendations of theSocietyfor Neuro-Oncology and the European Association of Neuro-Oncology, primary prevention with antiepileptic drugs should not be given [64], not even perioperatively [64,65].…”

Section: Epileptic Seizures and Epilepsymentioning

confidence: 99%

Antiepileptic pharmacotherapy in old age: evidence-based approach versus clinical routine – English Version

Holtkamp

2022

Z. Epileptol.

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With respect to epilepsy in old age, two groups of patients with different needs and challenges must be distinguished, which are also treated separately in this article: those who have grown old with epilepsy and those with epilepsy occurring for the first time in older age. Diagnostically, the first group is unproblematic as there are only relatively rarely patients with a misdiagnosis of epilepsy that has been maintained over decades. In contrast, epilepsy beginning in older age is more often misdiagnosed or diagnosed with a delay because of the often comparatively harmless semiology including nonconvulsive status epilepticus. Therapeutically, the question of switching from an "old" antiepileptic drug with negative effects on electrolytes, hormones, bone density, hepatic and vitamin metabolism as well as on cognitive parameters, such as alertness and memory, to a "modern" agent frequently arises. While many of these newer compounds offer benefits there are always surprises with unexpected, particularly psychiatric, adverse effects. If the patient has been seizure-free for a long time, the question of discontinuing or at least reducing the dose of antiepileptic drugs naturally arises. At the onset of epilepsy in old age, the selection of an antiepileptic drug, which usually needs to be taken for the rest of the patient's life, requires special consideration of individual aspects, not least because of the often numerous comorbidities and already existing medications. The aim of this article is to present the current state of knowledge and to assist in the care of older patients in the area of conflict between the limited evidence-based data and the necessity of a therapeutic decision in routine clinical practice.

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Efficacy of perioperative anticonvulsant prophylaxis in seizure-naïve glioma patients: A meta-analysis

Cited by 8 publications

References 25 publications

Levetiracetam Prophylaxis Therapy for Brain Tumor-Related Epilepsy (BTRE) Is Associated With a Higher Psychiatric Burden

Levetiracetam Prophylaxis Therapy for Brain Tumor-Related Epilepsy (BTRE) Is Associated With a Higher Psychiatric Burden

Brain Tumor Rehabilitation: Symptoms, Complications, and Treatment Strategy

Antiepileptic pharmacotherapy in old age: evidence-based approach versus clinical routine – English Version

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