Levetiracetam: preliminary experience in patients with primary brain tumours

Wagner, G; Wilms, Erik B; Donselaar, Cees A. van; Vecht, Ch.J.

doi:10.1016/s1059-1311(03)00096-7

Cited by 117 publications

(65 citation statements)

References 7 publications

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“…52 A large number of smaller studies have also shown levetiracetam to be well tolerated in brain tumor patients, with somnolence or other behavioral side effects being the most common adverse events, 31,37,40,41,55,64 with adverse effects being mostly reversible with dose reduction or displacement. 31,34,67 Levetiracetam demonstrated significantly fewer adverse effects than phenytoin when AED prophylaxis was given for supratentorial surgery, along with statistically equal efficacy (1% vs 4.3% early seizure incidence). 37 In contrast, patients given phenytoin were more likely to experience adverse effects than a seizure (18% vs 4%), and were much less likely to remain on the medication 1 year after surgery than with levetiracetam (26% vs 64%).…”

Section: The New Generation Of Antiepileptic Drugs: Levetiracetammentioning

confidence: 99%

Anticonvulsant prophylaxis for brain tumor surgery: determining the current best available evidence

Sayegh

Fakurnejad²,

Oh³

et al. 2014

JNS

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Patients who undergo craniotomy for brain tumor resection are prone to experiencing seizures, which can have debilitating medical, neurological, and psychosocial effects. A controversial issue in neurosurgery is the common practice of administering perioperative anticonvulsant prophylaxis to these patients despite a paucity of supporting data in the literature. The foreseeable benefits of this strategy must be balanced against potential adverse effects and interactions with critical medications such as chemotherapeutic agents and corticosteroids. Multiple disparate metaanalyses have been published on this topic but have not been applied into clinical practice, and, instead, personal preference frequently determines practice patterns in this area of management. Therefore, to select the current best available evidence to guide clinical decision making, the literature was evaluated to identify meta-analyses that investigated the efficacy and/or safety of anticonvulsant prophylaxis in this patient population. Six meta-analyses published between 1996 and 2011 were included in the present study. The Quality of Reporting of Meta-analyses and Oxman-Guyatt methodological quality assessment tools were used to score these meta-analyses, and the Jadad decision algorithm was applied to determine the highest-quality meta-analysis. According to this analysis, 2 metaanalyses were deemed to be the current best available evidence, both of which conclude that prophylactic treatment does not improve seizure control in these patients. Therefore, this management strategy should not be routinely used.

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Section: The New Generation Of Antiepileptic Drugs: Levetiracetammentioning

confidence: 99%

Anticonvulsant prophylaxis for brain tumor surgery: determining the current best available evidence

Sayegh

Fakurnejad²,

Oh³

et al. 2014

JNS

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“…AEDs may be associated with substantial adverse effects (Cascino, 2008;Cramer et al, 2010), such as cognitive deficits (Sisodiya et al, 2002;Wagner et al, 2003;Taphoorn and Klein, 2004), and some have suggested that first-generation medications may result in more side-effects in glioma patients than in other patients with epilepsy (Glantz et al, 2000;Batchelor and Byrne, 2006;Merrell et al, 2010a). In one large European survey of patients with epilepsy, Baker et al (1997) observed that 31% of individuals changed AEDs at least once in the preceding year because of sideeffects, and 44% were concerned about possible side-effects related to these medications.…”

Section: Adverse Effects Of Aedsmentioning

confidence: 99%

Epilepsy and Brain Tumors

Newton

Maschio²,

Pritikin³

2015

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Seizures are common in patients with brain tumors, and epilepsy can significantly impact patient quality of life. Therefore, a thorough understanding of rates and predictors of seizures, and the likelihood of seizure freedom after resection, is critical in the treatment of brain tumors. Among all tumor types, seizures are most common with glioneuronal tumors (70-80%), particularly in patients with frontotemporal or insular lesions. Seizures are also common in individuals with glioma, with the highest rates of epilepsy (60-75%) observed in patients with low-grade gliomas located in superficial cortical or insular regions. Approximately 20-50% of patients with meningioma and 20-35% of those with brain metastases also suffer from seizures. After tumor resection, approximately 60-90% are rendered seizure-free, with most favorable seizure outcomes seen in individuals with glioneuronal tumors. Gross total resection, earlier surgical therapy, and a lack of generalized seizures are common predictors of a favorable seizure outcome. With regard to anticonvulsant medication selection, evidence-based guidelines for the treatment of focal epilepsy should be followed, and individual patient factors should also be considered, including patient age, sex, organ dysfunction, comorbidity, or cotherapy. As concomitant chemotherapy commonly forms an essential part of glioma treatment, enzyme-inducing anticonvulsants should be avoided when possible. Seizure freedom is the ultimate goal in the treatment of brain tumor patients with epilepsy, given the adverse effects of seizures on quality of life.

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“…In another uncontrollled, retrospective study, oxcarbazepine (OCX) was better tolerated than previous « firstgeneration » AED , although the risk of cutaneous rash may be sensitized by radiotherapy (Maschio, Dinapoli et al). Zonisamide had been studied as add-on therapy in patients with BTE Levetiracetam (LEV) was recently introduced as an interesting alternative for BTE treatment (Wagner, Wilms et al 2003). In a uncontrolled prospective study, LEV was shown to be well tolerated and provided a good seizure improvement in 17 patients with BTE (Usery, Michael et al, 2009).…”

Section: -5 Antiepileptic Pharmacotherapymentioning

confidence: 99%

Brain tumor epilepsy: A reappraisal and six remaining issues to be debated

Vercueil

2011

Revue Neurologique

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Epilepsy associated with brain tumors presents with specific features deserving medical attention : 1) although commonly reported in patients with brain tumor, either as revealing mode or as a remote complication, limited knowledge is available regarding their epidemiology, clinical evolution, surgical outcome, physiopathology and treatment, providing only clues for clinical management. 2) seizures appear even more threatening for patients and care-givers, providing seizures could meant tumor progression and recurrence. This factor adds to the negative impact epilepsy carry on quality of life measures. 3) pharmacotherapy is complicated by the use of chemotherapy and interaction between antiepileptic drugs and antineoplastic agents are frequent and potentially harmful. 4) the high incidence of epilepsy enlights the question of prophylaxy with antiepileptic drugs, in patients without seizures, or during the perioperative period, and after surgery, when gross total resection has been achieved. This article attempts to provide the reader with an overview of brain tumor epilepsy in its specific aspects and to comment on some remaining issues.

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Levetiracetam: preliminary experience in patients with primary brain tumours

Cited by 117 publications

References 7 publications

Anticonvulsant prophylaxis for brain tumor surgery: determining the current best available evidence

Anticonvulsant prophylaxis for brain tumor surgery: determining the current best available evidence

Epilepsy and Brain Tumors

Brain tumor epilepsy: A reappraisal and six remaining issues to be debated

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