Antiepileptic drug-related neuropsychiatric adverse events in brain tumor-related epilepsy: levetiracetam front and center

BACKGROUND: Although overtreatment with antiepileptic drugs contributes to the morbidity associated with epilepsy, many children still are overtreated. OBJECTIVE: To evaluate if the withdrawal of at least one antiepileptic drug (AED) in children with refractory epilepsy using polytherapy enable a better seizure control. METHOD: This was a prospective study. Children with refractory epilepsy using at least two AEDs were included. Once the patient, or guardian, agreed to participate in the study, one or more AED were slowly tapered off. The remaining AEDs dosages could be adjusted as needed, but a new AED could not be introduced. RESULTS: Fifteen patients were evaluated, three girls; ages ranging from 3 to 18 (mean=8.7 years). After at least one AED withdrawal, two (13.5%) patients became seizure free, seizures improved >50% in 5 (33.5%) patients, did not change in 5 (33.5%), and seizure frequency became worse in 3 (20%). Adverse events improved in 12 patients (80%). CONCLUSION: The withdrawal of at least one AED is a valuable option in the treatment of selected children with refractory epilepsy.

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Resident participation is not associated with postoperative adverse events, reoperation, or prolonged length of stay following craniotomy for brain tumor resection

Journal of Neuro-Oncology ◽

10.1007/s11060-017-2614-6 ◽

2017 ◽

Vol 135 (3) ◽

pp. 613-619 ◽

Cited By ~ 4

Author(s):

Nikita Lakomkin ◽

Constantinos G. Hadjipanayis

Keyword(s):

Brain Tumor ◽

Length Of Stay ◽

Adverse Events ◽

Tumor Resection ◽

Resident Participation ◽

Prolonged Length ◽

Brain Tumor Resection

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A National Consensus Survey for Current Practice in Brain Tumor Management I: Antiepileptic Drug and Steroid Usage

Brain Tumor Research and Treatment ◽

10.14791/btrt.2020.8.e5 ◽

2020 ◽

Vol 8 (1) ◽

pp. 1

Author(s):

Sung Kwon Kim ◽

Jangsup Moon ◽

Jin Mo Cho ◽

Kyung Hwan Kim ◽

Se Hoon Kim ◽

...

Keyword(s):

Brain Tumor ◽

Antiepileptic Drug ◽

Current Practice ◽

National Consensus ◽

Tumor Management

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SURG-15. RESIDENT PARTICIPATION IS NOT ASSOCIATED WITH POSTOPERATIVE ADVERSE EVENTS, REOPERATION, OR PROLONGED LENGTH OF STAY FOLLOWING CRANIOTOMY FOR BRAIN TUMOR RESECTION

Neuro-Oncology ◽

10.1093/neuonc/nox168.972 ◽

2017 ◽

Vol 19 (suppl_6) ◽

pp. vi238-vi238

Author(s):

Nikita Lakomkin ◽

Constantinos Hadjipanayis

Keyword(s):

Brain Tumor ◽

Length Of Stay ◽

Adverse Events ◽

Tumor Resection ◽

Resident Participation ◽

Prolonged Length ◽

Brain Tumor Resection

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Adverse events in brain tumor surgery: incidence, type, and impact on current quality metrics

Acta Neurochirurgica ◽

10.1007/s00701-018-03790-4 ◽

2019 ◽

Vol 161 (2) ◽

pp. 287-306 ◽

Cited By ~ 4

Author(s):

Stephanie Schipmann ◽

Tobias Brix ◽

Julian Varghese ◽

Nils Warneke ◽

Michael Schwake ◽

...

Keyword(s):

Brain Tumor ◽

Adverse Events ◽

Quality Metrics ◽

Tumor Surgery ◽

Brain Tumor Surgery ◽

Surgery Incidence

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AED Treatment through Different Ages: As Our Brains Change, Should Our Drug Choices Also?

Epilepsy Currents ◽

10.5698/1535-7511-12.4s.22 ◽

2012 ◽

Vol 12 (4_suppl) ◽

pp. 22-27 ◽

Cited By ~ 11

Author(s):

Jacqueline A. French ◽

Brigid A. Staley

Keyword(s):

Adverse Events ◽

Antiepileptic Drug ◽

Hepatic Metabolism ◽

Drug Formulations ◽

Serious Adverse Events ◽

Patient Age ◽

Brain Physiology ◽

Patient Âgé ◽

Different Ages ◽

Selection Of

Patient age can impact selection of the optimal antiepileptic drug for a number of reasons. Changes in brain physiology from neonate to elderly, as well as changes in underlying etiologies of epilepsy, could potentially affect the ability of different drugs to control seizures. Unfortunately, much of this is speculative, as good studies demonstrating differences in efficacy across age ranges do not exist. Beyond the issue of efficacy, certain drugs may be more or less appropriate at different ages because of differing pharmacokinetics, including changes in hepatic metabolism, absorption, and elimination. Lack of appropriate drug formulations (such as liquid forms) may be a barrier to using drugs in the very young. Finally, some serious adverse events are seen either exclusively or preferentially at different ages.

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P18.06 * ZONISAMIDE AS ADD-ON ANTIEPILEPTIC DRUG IN PATIENTS WITH BRAIN TUMOR-RELATED EPILEPSY: PRELIMINARY DATA OF A PILOT STUDY

Neuro-Oncology ◽

10.1093/neuonc/nou174.430 ◽

2014 ◽

Vol 16 (suppl 2) ◽

pp. ii111-ii111

Author(s):

M. Maschio ◽

S. Dispenza ◽

L. Dinapoli ◽

D. Giannarelli ◽

A. Fabi ◽

...

Keyword(s):

Brain Tumor ◽

Pilot Study ◽

Antiepileptic Drug ◽

Preliminary Data

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Tumor Type, Epilepsy Burden, and Seizure Documentation: Experiences at a Single Center Neuro-Oncology Clinic

Neuro-Oncology Practice ◽

10.1093/nop/npab032 ◽

2021 ◽

Author(s):

Omar Bushara ◽

Alex Guzner ◽

Elizabeth Bachman ◽

Roger Stupp ◽

Rimas V Lukas ◽

...

Keyword(s):

Brain Tumor ◽

Clinical Practice ◽

Brain Tumors ◽

Antiepileptic Drug ◽

Retrospective Review ◽

Future Research ◽

Tumor Type ◽

Single Center ◽

Metastatic Brain Tumors ◽

Full Cohort

Abstract Background Patients with both primary and metastatic brain tumors have significant seizure burden due to their tumor. The management of tumor related epilepsy (TRE) and optimizing antiepileptic drug (AED) regimen requires collaboration between neurologists and seizure specialists, which is facilitated by seizure documentation in clinic notes. We aim to describe seizure incidence in patients seen in neuro-oncology clinical practice. Further, in the subset of those patients with TRE, we aim to analyze seizure documentation. Methods This is a retrospective review of patients with a primary or metastatic brain tumor seen in a neuro-oncology clinic in October 2019. Patients with TRE were included in the analysis of seizure documentation. These notes were analyzed for inclusion of seizure descriptors, terminology, AED regimens, and changes in management. Results Of the full cohort of 356 patients, 199 (55.9%) had TRE. Anaplastic astrocytomas had the highest percentage of patients with TRE. The analysis of seizure documentation in patients with TRE revealed that the majority of notes (90.9%) mentioned seizures. Fewer notes (39.6%) provided additional descriptions of the seizures or commented on AED regimens (58.3%). In notes for patients who had seizures within the previous 6 months, seizure descriptors were more likely. Conclusions This study defines the TRE burden in a cohort of patients seen in neuro-oncology clinic. Among patients with TRE, our study shows that documentation of many aspects of the characteristics and management of patient seizures can be improved, which would facilitate further analysis of impact on patient care as well as future research.

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