scholarly journals Treatment of epilepsy associated with primary and metastatic brain tumors

2021 ◽  
Vol 13 (3) ◽  
pp. 286-304
Author(s):  
A V. Lebedeva ◽  
S. G. Burd ◽  
P. N. Vlasov ◽  
N. A. Ermolenko ◽  
I. A. Zhidkova ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Epileptic Seizures ◽  
Metastatic Brain Tumors ◽  
First Line ◽  
Hepatic Microsomal Enzyme ◽  
Elevated Rate ◽  
Patients With Epilepsy ◽  
Microsomal Enzyme Inducers ◽  
Chemotherapy Agents

There is a number of unsolved issues in management of epilepsy associated with primary and metastatic brain tumors (BTs). In particular, no consensus approaches to treatment of patients with epilepsy associated with BTs have been proposed regarding use of current anti-epileptic drugs (AEDs). The review presents the relevant data on epidemiology, features of clinically manifested epilepsy at varying stages of BTs, aspects of drug-drug interaction between AEDs and anti-tumor agents, AED-related effects on cognitive functions as well as quality of life in patients with epilepsy associated with BTs. Levetiracetam and valproic acid comprise the first-line drugs for treating seizures in patients with BTs. It is unreasonable to use AEDs acting as hepatic microsomal enzyme inducers for therapy of epileptic seizures in BTs, because it may decrease efficacy of chemotherapy agents and glucocorticoids along with elevated rate of side effects. Perampanel acting as a selective noncompetitive AMPA receptor antagonist, may be one of the drugs of choice for the adjunctive therapy of epileptic seizures associated with BTs.

scholarly journals Surgical management of brain metastases

2007 ◽  
Vol 22 (3) ◽  
pp. 1-7 ◽  
Author(s):  
Moksha G. Ranasinghe ◽  
Jonas M. Sheehan
Keyword(s):  
Brain Tumors ◽  
Systemic Disease ◽  
Postoperative Management ◽  
Study Data ◽  
Preoperative Imaging ◽  
Metastatic Brain Tumors ◽  
Patients With Cancer ◽  
Proper Patient Selection ◽  
Positive Effect

✓Metastatic brain tumors continue to increase in incidence as patients with cancer live longer. The options for management continue to evolve as well, with advances in radiation-based treatment, chemotherapy, and surgery. Although metastatic brain tumors are frequently treated without surgical intervention, there continues to be a significant role for surgery in caring for patients with these lesions. Study data have proven that surgery has a positive effect on survival and quality of life in properly selected patients. Those with a suitable age, functional status, systemic disease control, and several metastases may be suitable for surgical treatment. Advances in preoperative imaging and planning as well as intraoperative surgical adjuncts have lowered the morbidity associated with resection. With proper patient selection and operative and postoperative management, resection continues to play a significant and evolving role in the care of patients with metastatic brain tumor.

scholarly journals The effects of epileptic seizures upon quality of life

2009 ◽  
Vol 15 (3) ◽  
pp. 110-113 ◽  
Author(s):  
Priscila Camile Barioni Salgado ◽  
Fernando Cendes
Keyword(s):  
Quality Of Life ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Epileptic Seizures ◽  
Anxiety And Depression ◽  
Co Morbidity ◽  
Item Quality ◽  
Patients With Epilepsy ◽  
And Control

OBJECTIVE: understand the psychological considerations of the relationship between the effect of seizures upon the patients' perception of seizure control, depression, anxiety and quality of life (QoL). METHODS: 151 adult patients with epilepsy diagnosed for over two years were interviewed and responded the 31-Item Quality of Life in Epilepsy (QOLIE-31), the Trait Form of the State/Trait Anxiety Inventory (STAI II) and the Beck Depression Inventory (BDI). RESULTS: 45 patients were depressed (29.8%) and 29 (19.2%) had anxiety. Depression scores ranged from 0 to 49 (M=7.4; SD=8.9) and anxiety scores ranged from 19 to 69 (M=41.5, SD=11.9). Total QoL score was correlated to seizure control (p<0.001), perception of epilepsy control (p<0.001), anxiety (p<0.001), and depression (p=0.003). The perception of epilepsy control was correlated to seizure control (p<0.001), seizure frequency (p=0.001), anxiety (p<0.001) and depression (p<0.001). Seizure control was associated to anxiety (p=0.033) and depression (p<0.001). There was co-morbidity between anxiety and depression (p<0.001). CONCLUSION: This study highlights the importance of the seizure frequency and control to the evaluation of perception of epilepsy control and shows that anxiety and depression in epilepsy are predicted by seizure-related (seizure frequency and control) and psychosocial aspects (perception of control and QoL) together.

scholarly journals Use of cannabidiol as a therapeutic method in epilepsy

2021 ◽  
Author(s):  
Mariana Soares ◽  
Ana Clara Mota Gonçalo ◽  
Kaline dos Santos Kishishita Castro ◽  
Victoria de Menezes Sá Lazera
Keyword(s):  
Cannabis Sativa ◽  
Epileptiform Activity ◽  
Neural Tissue ◽  
Epileptic Seizures ◽  
Cb1 Receptors ◽  
Study Results ◽  
Therapeutic Properties ◽  
Patients With Epilepsy ◽  
System Objective

Introduction: Cannabis sativa has several therapeutic properties and has been used for millennials for healing purposes. Among its benefits are analgesic, antiemetic and tranquilizing effects, acting strongly on the nervous system. Objective: This study aims to emphasize the importance of Cannabidiol as a therapeutic purpose for epilepsy, especially in Brazil, where its use is still controlled. Method: A systematic literature review, using bibliographic searches carried out in the electronic databases LILACS, PubMed and SciELO with the descriptors “cannabidiol” and “epilepsy”. Of 1645 searches found, 06 were used in the study. Results: Epileptic seizures can be generalized or partial and are determined by the affected area. The treatment for epilepsy are drugs that decrease the arousal capacity of neural tissue and a significant percentage of individuals cannot control them with traditional drugs alone. Endocannabinoids work in response to epileptiform activity, to activate CB1 receptors for excitatory neurons, to contain excess neuronal activity, which occurs during seizures. It is proven that patients who use it do not have toxic adverse effects. Conclusions: In Brazil, Cannabis is a controlled drug and the fact that it is imported, interfere in the treatment, who is interrupted while patient waits the new dosage. The importance of cannabidiol as a target for research and studies is verified, as it has ample potential in the treatment of epilepsy and reduces brain damage caused by it. In order that patients with epilepsy, have improvements in their quality of life.

scholarly journals Cognitive Impairments in Young Men Suffering from Epilepsy

2019 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Epileptiform Activity ◽  
Nervous Activity ◽  
Cognitive Disorders ◽  
Epileptic Seizures ◽  
Diagnostic Methods ◽  
Central System ◽  
Underlying Factor ◽  
Wide Range ◽  
Patients With Epilepsy

Epilepsy is a chronic disease of the central system with a wide range of neuropsychiatric disorders. Cognitive disorders are quite common with this disease and significantly reduce the quality of life of patients and their families. In approximately 35% of patients, despite treatment, various impairments of memory, attention and bradyphrenia persist in the interictal period. Causes of cognitive impairment in patients with epilepsy can be directly the underlying factor of epilepsy (genetic disease, structural brain defect, etc.), epileptic seizures, interictal epileptiform activity, side effects of antiepileptic drugs (AEDs). Modern neurophysiological and neuroimaging diagnostic methods allow us to identify new features of the course and progression of dysfunctions of higher nervous activity in epilepsy

Features of affective disorders correction in patients with epilepsy (therapy, rehabilitation, prevention)

2021 ◽  
Vol 90 (1) ◽  
pp. 52-61
Author(s):  
H. Kozhyna ◽  
I. Strelnikova ◽  
M. Khaustov
Keyword(s):  
Quality Of Life ◽  
Affective Disorders ◽  
Depressive Disorders ◽  
Epileptic Seizures ◽  
Psychosocial Adaptation ◽  
Keywords Epilepsy ◽  
Constant Attention ◽  
Clinical Prognosis ◽  
Patients With Epilepsy

For many decades, epilepsy has remained a serious medical and social problem that requires constant attention not only from neurologists, psychiatrists, but also from medical psychologists and social workers. The priority in the treatment of epilepsy is not only to prevent seizures, but also to help the patient maintain social functioning and restore quality of life. Achieving drug remission of epileptic seizures is only part of the management of the disease, it is necessary to help restore the patient's psychosocial adaptation and form a correct understanding of their disease and related limitations in daily functioning. A comprehensive examination which involved 65 patients with epilepsy of both sexes aged 18–40 years was conducted in compliance with the principles of bioethics and medical deontology. The mean age of the subjects ranged from (34.0±1.6) years, duration of the disease in patients did not exceed 10 years. All subjects had disorders of the emotional sphere of non-psychotic level, which were recorded in the interictal period of the disease. Selected comprehensive system of correction of affective disorders in patients with epilepsy helped to achieve following results, especially: reduction of anxiety and depressive disorders (73.5 %), reducing the level of motor and ideational inhibition (65.2 %), reducing the intensity and duration of depressive affect (72.5 %), restoration of interest in activities that previously interested patients (69.5 %), improvement of psychosocial adaptation (81.3 %), managed to achieve the transition of maladaptive types of attitudes to the disease to adaptive (66.5 %) and improve quality of life (83.2 %). A study of affective disorders in patients with epilepsy allowed us to make following conclusions: epilepsy is often combined with affective disorders. Depressive disorders are more common among all affective disorders. Epilepsy and affective disorders interact with each other and complicate clinical prognosis. Keywords: epilepsy, affective disorders, rehabilitation, psychoeducation.

scholarly journals Influence of Epilepsy on the Quality of Life of Patients with Brain Tumors

2021 ◽  
Vol 18 (12) ◽  
pp. 6390
Author(s):  
Stanisław Krajewski ◽  
Magdalena Wójcik ◽  
Marek Harat ◽  
Jacek Furtak
Keyword(s):  
Quality Of Life ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Categorical Variables ◽  
P Value ◽  
Memory Disorders ◽  
Generalized Seizures ◽  
Daily Physical Activities ◽  
Patients With Epilepsy

Epilepsy is a common consequence of brain tumors, occurring in 35 to 75% of cases. Here we evaluated the influence of epilepsy on the quality of life (QoL) of patients with malignant brain tumors (primary and metastatic) and assessed which areas of function are most affected by epilepsy and brain tumors. Sixty patients undergoing brain tumor surgery at the Neurosurgery Clinic of the 10th Military Research Hospital, Bydgoszcz, Poland (30 with epilepsy and 30 without epilepsy) were studied. Relationships between categorical variables were determined with Pearson’s chi-squared test, while continuous data were analyzed with the Mann-Whitney U-test. A p value < 0.05 was considered statistically significant. A multiple regression model was used for multivariate analysis of QoL. Patients with epilepsy more frequently reported memory disorders as a problem in their daily life. There were trends towards greater impairments in social, professional, and family life, sports and recreational activities, and daily physical activities in brain tumor patients with epilepsy rather than those without epilepsy. Higher frequency and generalized seizures significantly and adversely influenced the ability of patients to leave home and drive vehicles, but a proportion of patients with frequent, generalized seizures continued to drive regardless. Patients with generalized seizures considered the adverse effects of taking medicines as significantly disruptive. Memory disorders significantly affect the QoL of patients with epilepsy, and the importance of stopping driving must be emphasized by all healthcare professionals.

scholarly journals Seizure Forecasting and the Preictal State in Canine Epilepsy

2016 ◽  
Vol 27 (01) ◽  
pp. 1650046 ◽  
Author(s):  
Yogatheesan Varatharajah ◽  
Ravishankar K. Iyer ◽  
Brent M. Berry ◽  
Gregory A. Worrell ◽  
Benjamin H. Brinkmann
Keyword(s):  
Machine Learning ◽  
Epileptic Seizures ◽  
Machine Learning Algorithms ◽  
Challenging Problem ◽  
Multiple Features ◽  
Feature Sets ◽  
Machine Learning Methods ◽  
Patients With Epilepsy ◽  
Preictal State

The ability to predict seizures may enable patients with epilepsy to better manage their medications and activities, potentially reducing side effects and improving quality of life. Forecasting epileptic seizures remains a challenging problem, but machine learning methods using intracranial electroencephalographic (iEEG) measures have shown promise. A machine-learning-based pipeline was developed to process iEEG recordings and generate seizure warnings. Results support the ability to forecast seizures at rates greater than a Poisson random predictor for all feature sets and machine learning algorithms tested. In addition, subject-specific neurophysiological changes in multiple features are reported preceding lead seizures, providing evidence supporting the existence of a distinct and identifiable preictal state.

Increased Permeability of the Blood-Brain Barrier to Chemotherapy in Metastatic Brain Tumors: Establishing a Treatment Paradigm

2007 ◽  
Vol 25 (16) ◽  
pp. 2306-2312 ◽  
Author(s):  
Elizabeth R. Gerstner ◽  
Robert L. Fine
Keyword(s):  
Brain Tumors ◽  
Natural Product ◽  
Blood Brain Barrier ◽  
Brain Barrier ◽  
Major Protein ◽  
Normal Brain ◽  
Metastatic Brain Tumors ◽  
Chemotherapy Drugs ◽  
Blood Brain ◽  
Chemotherapy Agents

There is no accepted standard of care for the chemotherapy treatment of metastatic brain tumors, which has been generally limited to lipophilic alkylators, which may not have efficacy against the tumor that metastasized to the brain. More than 50% of chemotherapy agents are natural product drugs, which are rarely used in the treatment of metastatic brain tumors because they are thought to not cross the blood-brain barrier (BBB). A major protein constituent in the BBB is P-glycoprotein (P-gp), which pumps natural product chemotherapy drugs and toxins out of the CNS. However, P-gp expression in the neovasculature of metastatic brain tumors is similar to the P-gp expression in the neovasculature of the primary, extracranial tumor. In contrast, gliomas have higher P-gp expression in their neovasculature, similar to the greater intrinsic expression of P-gp in normal brain vasculature. This decreased immunohistochemical expression of P-gp in the neovasculature of metastatic tumors, as well as our recent pharmacologic demonstration of increased tissue concentrations of paclitaxel in metastatic brain tumors compared with gliomas, support the idea that the choice of chemotherapy agents should be based on the histologic origin of the metastatic brain tumor and not on the lipophilicity of the drug. Our hypothesis is that metastatic brain tumors from tumors with intrinsically low P-gp expression (eg, lung, melanoma, and untreated breast) may be more permeable to natural product chemotherapy drugs than gliomas. This information could lead to a paradigm shift in the use of natural product drugs for metastatic brain tumors.

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