An overview of anti-epileptic therapy management of patients with malignant tumors of the brain undergoing radiation therapy.

TitleAn overview of anti-epileptic therapy management of patients with malignant tumors of the brain undergoing radiation therapy.
Publication TypeJournal Article
Year of Publication2019
AuthorsJulie DAR, Ahmed Z, Karceski SC, Pannullo SC, Schwartz TH, Parashar B, A Wernicke G
JournalSeizure
Volume70
Pagination30-37
Date Published2019 Aug
ISSN1532-2688
KeywordsAnticonvulsants, Brain Neoplasms, Cranial Irradiation, Disease Management, Epilepsy, Glioma, Humans, Seizures
Abstract

As our surgical, radiation, chemotherapeutic and supportive therapies for brain malignancies improve, and overall survival is prolonged, appropriate symptom management in this patient population becomes increasingly important. This review summarizes the published literature and current practice patterns regarding prophylactic and perioperative anti-epileptic drug use. As a wide range of anti-epileptic drugs is now available to providers, evidence guiding appropriate anticonvulsant choice is reviewed. A particular focus of this article is radiation therapy for brain malignancies. Toxicities and seizure risk associated with cranial irradiation will be discussed. Epilepsy management in patients undergoing radiation for gliomas, glioblastoma multiforme, and brain metastases will be addressed. An emerging but inconsistent body of evidence, reviewed here, indicates that anti-epileptic medications may increase radiosensitivity, and therefore improve clinical outcomes, specifically in glioblastoma multiforme patients.

DOI10.1016/j.seizure.2019.06.019
Alternate JournalSeizure
PubMed ID31247400