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Patients with brain tumor-related epilepsy

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Abstract

Patients with brain tumor-related epilepsy (BTRE) present a complex therapeutic profile and require a unique and multidisciplinary approach. They, in fact, must face two different pathologies at the same time, brain tumor and epilepsy. Therefore, it is necessary to develop a customized treatment plan for each individual with BTRE. This requires a vision of patient management concerned not only with medical therapies related to the oncological disease and to the correct choice of antiepileptic therapies but also with emotional and psychological support for the individual and his/her family. The choice of antiepileptic drugs is challenging for these patients because BTRE is often drug-resistant, has a strong impact on the quality of life, and weighs heavily on public health expenditures. In brain tumor patients, the presence of epilepsy is considered the most important risk factor for long-term disability. The problem of the proper administration of medications and their potential side effects is of great importance, because good seizure control also has a significant impact on the patient’s psychological and relational sphere.

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References

  1. Hildebrand J (2004) Management of epileptic seizures. Curr Opin Oncol 16:314–317

    Article  PubMed  Google Scholar 

  2. Werner MH, Phuphanich S, Lyman GH (1995) The increasing incidence of malignant gliomas and primary central nervous system lymphoma in the elderly. Cancer 76:1634–1642

    Article  PubMed  CAS  Google Scholar 

  3. Rossetti AO, Stupp R (2010) Epilepsy in brain tumor patients. Curr Opin Neurol 23:603–609

    Article  PubMed  CAS  Google Scholar 

  4. Singh G, Rees JH, Sander JW (2007) Seizures and epilepsy in oncological practice: causes, course, mechanisms and treatment. J Neurol Neurosurg Psychiatry 78:342–349

    Article  PubMed  Google Scholar 

  5. Glantz MJ, Cole BF, Forsyth PA et al (2000) Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Neurology 54:1886–1893

    Article  PubMed  CAS  Google Scholar 

  6. Hildebrand J, Lecaille C, Perennes J, Delattre JY (2005) Epileptic seizures during follow-up of patients treated for primary brain tumors. Neurology 65:212–215

    Article  PubMed  Google Scholar 

  7. Wen PY, Marks PW (2002) Medical management of patients with brain tumors. Curr Opin Oncol 14:299–307

    Article  PubMed  Google Scholar 

  8. Telfeian AE, Philips MF, Crino PB, Judy KD (2001) Postoperative epilepsy in patients undergoing craniotomy for glioblastoma multiforme. J Exp Clin Cancer Res 20:5–10

    PubMed  CAS  Google Scholar 

  9. Luyken C, Blümcke I, Fimmers R et al (2003) The spectrum of long-term epilepsy-associated tumors: long-term seizure and tumor outcome and neurosurgical aspects. Epilepsia 44:822–830

    Article  PubMed  Google Scholar 

  10. Vecht CJ, Wilms EB (2010) Seizures in low- and high-grade gliomas: current management and future outlook. Expert Rev Anticancer Ther 10:663–669

    Article  PubMed  Google Scholar 

  11. DeAngelis LM (2001) Brain tumors. N Engl J Med 344:114–123

    Article  PubMed  CAS  Google Scholar 

  12. Kargiotis O, Markoula S, Kyritsis AP (2011) Epilepsy in the cancer patient. Cancer Chemother Pharmacol 67:489–501

    Article  PubMed  CAS  Google Scholar 

  13. Maschio M, Dinapoli L, Sperati F et al (2010) Levetiracetam monotherapy in patients with brain tumor-related epilepsy: seizure control, safety, and quality of life. J Neurooncol 104:205–214

    Article  PubMed  Google Scholar 

  14. Schaller B, Ruegg SJ (2003) Brain tumor and seizures: pathophysiology and its implications for treatment revised. Epilepsia 44:1223–1232

    Article  PubMed  Google Scholar 

  15. Whittle IR, Beaumont A (1995) Seizures in patients with supratentorial oligodendroglial tumors: clinicopathological features and management considerations. Acta Neurochir 135:19–24

    Article  CAS  Google Scholar 

  16. Kwan P, Arzimanoglou A, Berg AT et al (2010) Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 51:1069–1077

    Article  PubMed  CAS  Google Scholar 

  17. Jaeckle KA, Ballman K, Furth A, Buckner JC (2009) Correlation of enzyme-inducing anticonvulsant use with outcome of patients with glioblastoma. Neurology 73:1207–1213

    Article  PubMed  CAS  Google Scholar 

  18. Patsalos PN, Froscher W, Pisani F, van Rijn C (2002) The importance of drugs interactions in epilepsy therapy. Epilepsia 43:365–385

    Article  PubMed  CAS  Google Scholar 

  19. Patsalos PN, Perucca E (2003) Clinically important drug interactions in epilepsy: general features and interactions between antiepileptic drugs. Lancet Neurol 2:347–356

    Article  PubMed  CAS  Google Scholar 

  20. Vecht CJ, Wagner GL, Wilms EB (2003) Interactions between antiepileptic and chemotherapeutic drugs. Lancet Neurol 2:404–409

    Article  PubMed  CAS  Google Scholar 

  21. Löscher W (2005) How to explain multidrug resistance in epilepsy? Epilepsy Curr 5:107–112

    Article  PubMed  Google Scholar 

  22. Taillibert S, Laigle-Donadey F, Sanson M (2004) Palliative care in patients with primary brain tumors. Curr Opin Oncol 16:587–592

    Article  PubMed  Google Scholar 

  23. Klein M, Engelberts NHJ, van der Ploeg HM et al (2003) Epilepsy in lowgrade gliomas: the impact on cognitive function and quality of life. Ann Neurol 54:514–520

    Article  PubMed  Google Scholar 

  24. Maschio M, Dinapoli L, Gomellini S et al (2010) Antiepileptics in brain metastases: safety, efficacy and impact on life expectancy. J Neurooncol 98:109–116

    Article  PubMed  CAS  Google Scholar 

  25. Maschio M, Dinapoli L, Saveriano F et al (2009) Efficacy and tolerability of zonisamide as add-on in brain tumor-related epilepsy: preliminary report. Acta Neurol Scand 120:210–212

    Article  PubMed  CAS  Google Scholar 

  26. Maschio M, Albani F, Baruzzi A et al (2006) Levetiracetam therapy in patients with brain tumour and epilepsy. J Neurooncol 80:97–100

    Article  PubMed  CAS  Google Scholar 

  27. Novy J, Stupp R, Rossetti AO (2009) Pregabalin in patients with primary brain tumors and seizures: a preliminary observation. Clin Neurol Neurosurg 111:171–173

    Article  PubMed  Google Scholar 

  28. Maschio M, Dinapoli L, Mingoia M et al (2011) Lacosamide as add-on in brain tumor-related epilepsy: preliminary report on efficacy and tolerability. J Neurol 258:2100–2104

    Article  PubMed  CAS  Google Scholar 

  29. Maschio M, Dinapoli L, Vidiri A et al (2009) The role side effects play in the choice of antiepileptic therapy in brain tumor-related epilepsy: a comparative study on traditional antiepileptic drugs versus oxcarbazepine. J Exp Clin Cancer Res 28:60

    Article  PubMed  Google Scholar 

  30. Beghi E (2004) Efficacy and tolerability of the new antiepileptic drugs: comparison of two recent guidelines. Lancet Neurol 3:321–618

    Article  Google Scholar 

  31. French JA, Kanner AM, Bautista J et al (2004) Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy. Neurology 62:1261–1273

    Article  PubMed  CAS  Google Scholar 

  32. Kwan P, Brodie MJ (2004) Phenobarbital for the treatment of epilepsy in the 21st century: a critical review. Epilepsia 45:1141–1149

    Article  PubMed  CAS  Google Scholar 

  33. Aguiar D, Pazo R, Duran I et al (2004) Toxic epidermal necrolysis in patients receiving anticonvulsants and cranial irradiation: a risk to consider. J Neurooncol 66:345–350

    Article  PubMed  Google Scholar 

  34. Bourg V, Lebrun C, Chichmanian RM et al (2001) Nitroso-urea-cisplatin-based chemotherapy associated with valproate: increase of haematologic toxicity. Ann Oncol 12:217–219

    Article  PubMed  CAS  Google Scholar 

  35. Wellington K, Goa KL (2001) Oxcarbazepine: an update of its efficacy in the management of epilepsy. CNS Drugs 15:137–163

    Article  PubMed  CAS  Google Scholar 

  36. Singh BK, White-Scott S (2002) Role of topiramate in adults with intractable epilepsy, mental retardation, and developmental disabilities. Seizure 11:47–50

    Article  PubMed  Google Scholar 

  37. Salinsky MC, Storzbach D, Spencer DC et al (2005) Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers. Neurology 64:792–798

    Article  PubMed  CAS  Google Scholar 

  38. Kilpatrick ES, Forrest G, Brodie MJ (1996) Concentration-effect and concentration-toxicity relations with lamotrigine: a prospective study. Epilepsia 37:534–538

    Article  PubMed  CAS  Google Scholar 

  39. Sander JW, Hart YM, Trimble MR, Shorvon SD (1991) Vigabatrin and psychosis. J Neurol Neurosurg Psychiatry 54:435–439

    Article  PubMed  CAS  Google Scholar 

  40. Dichter MA, Brodie MJ (1996) New antiepileptic drugs. N Engl J Med 334:1583–1590

    Article  PubMed  CAS  Google Scholar 

  41. Leppik IE (2002) Three new drugs for epilepsy: levetiracetam, oxcarbazepine and zonisamide. J Child Neurol 17(Suppl 1):S53–S57

    Article  PubMed  Google Scholar 

  42. Sheth RD (2004) Bone health in epilepsy. Lancet Neurol 3:516

    Article  PubMed  Google Scholar 

  43. Maschio M, Dinapoli L, Zarabla A et al (2008) Outcome and tolerability of topiramate in brain tumor associated epilepsy. J Neurooncol 86:61–70

    Article  PubMed  CAS  Google Scholar 

  44. Striano S, Striano P, Boccella P et al (2002) Tiagabine in glial tumors. Epilepsy Res 49:81–85

    Article  PubMed  CAS  Google Scholar 

  45. Khan RB, Hunt DL, Thompson SJ (2004) Gabapentin to control seizures in children undergoing cancer treatment. J Child Neurol 19:97–101

    PubMed  Google Scholar 

  46. Newton HB, Goldlust SA, Pearl D (2006) Retrospective analysis of the efficacy and tolerability of levetiracetam in brain tumor patients. J Neurooncol 78:99–102

    Article  PubMed  CAS  Google Scholar 

  47. Maschio M, Albani F, Jandolo B et al (2008) Temozolomide treatment does not affect topiramate and oxcarbazepine plasma concentrations in chronically treated patients with brain tumor-related epilepsy. J Neurooncol 90:217–221

    Article  PubMed  CAS  Google Scholar 

  48. Dinapoli L, Maschio M, Jandolo B et al (2009) Quality of life and seizure control in patients with brain tumor-related epilepsy treated with levetiracetam monotherapy: preliminary data of an open-label study. Neurol Sci 30:353–359

    Google Scholar 

  49. Maschio M, Dinapoli L, Vidiri A, Muti P (2010) Rash in four patients with brain tumor-related epilepsy in monotherapy with oxcarbazepine, during radiotherapy. J Neurol 157:1939–1940

    Article  Google Scholar 

  50. Salinsky MC, Storzbach D, Spencer DC et al (2005) Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers. Neurology 64:792–798

    Article  PubMed  CAS  Google Scholar 

  51. Sabers A, Møller A, Dam M et al (1995) Cognitive functions and anticonvulsivant therapy: effect of monotherapy in epilepsy. Acta Neurol Scand 92:19–27

    Article  PubMed  CAS  Google Scholar 

  52. Bosma I, Vos MJ, Heimans JJ, Taphoorn MJB et al (2007) The course of neurocognitive functioning in high grade glioma patients. Neurooncol 9:53–62

    Google Scholar 

  53. Taphoorn MJ, Klein M (2004) Cognitive deficits in adult patients with brain tumours. Lancet Neurol 3:159–168

    Article  PubMed  Google Scholar 

  54. Krychman ML, Amsterdam A, Carter J, Castiel M, DeAngelis L (2004) Brain cancer and sexual health: a case report. Palliat Support Care 2:315–318

    Article  PubMed  Google Scholar 

  55. Smaldone M, Sukkarieh T, Reda A, Khan A (2004) Epilepsy and erectile dysfunction: a review. Seizure 13:453–459

    Article  PubMed  CAS  Google Scholar 

  56. Holtkamp M, Weissinger F, Meierkord H (2005) Erectile dysfunction with topiramate. Epilepsia 46:166–167

    Article  PubMed  Google Scholar 

  57. Maschio M, Saveriano F, Dinapoli L, Jandolo B (2011) Reversible erectile dysfunction in a patient with brain tumor-related epilepsy in therapy with zonisamide in add-on. J Sex Med 8:3515–3517. doi:10.1111/j.1743-6109.2009.01373.x

    Article  PubMed  Google Scholar 

  58. Anderson GD (2004) Pharmacogenetics and enzyme induction/inhibition properties of antiepileptic drugs. Neurology 63(4):S3–S8

    Article  PubMed  CAS  Google Scholar 

  59. Yap KY, Chui WK, Chan A (2008) Drug interactions between chemotherapeutic regimens and antiepileptics. Clin Ther 30:1385–1407

    Article  PubMed  CAS  Google Scholar 

  60. Drappatz J, Schiff D, Kesari S et al (2007) Medical management of brain tumor patients. Neurol Clin 25:1035–1071

    Article  PubMed  Google Scholar 

  61. Rudà R, Trevisan E, Soffietti R (2010) Epilepsy and brain tumors. Curr Opin Oncol 22:611–620

    Article  PubMed  Google Scholar 

  62. Chavez-Blanco A, Perez-Plasencia C, Perez-Cardenas E et al (2006) Antineoplastic effects of the DNA methylation inhibitor hydralazine and the histone deacetylase inhibitor valproic acid in cancer cell lines. Cancer Cell Int 31(6):21

    Google Scholar 

  63. Maschio M, Dinapoli L, Zarabla A, Jandolo B (2006) Issues related to the pharmacological management of patients with brain tumours and epilepsy. Funct Neurol 21:15–19

    PubMed  Google Scholar 

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Acknowledgments

The authors wish to express their gratitude to Ms. Lesley Pritikin for reviewing the manuscript and for her precious support.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Center for Tumor-Related Epilepsy, Neurology Unit, Department of Neuroscience and Cervical-Facial Pathology, National Institute for Cancer “Regina Elena”, Via Elio Chianesi 53, 00144, Rome, Italy

    Marta Maschio & Loredana Dinapoli

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  1. Marta Maschio
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  2. Loredana Dinapoli
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Correspondence to Marta Maschio.

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Maschio, M., Dinapoli, L. Patients with brain tumor-related epilepsy. J Neurooncol 109, 1–6 (2012). https://doi.org/10.1007/s11060-012-0867-7

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  • DOI: https://doi.org/10.1007/s11060-012-0867-7

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