Current Treatment Options in Oncology, Год журнала: 2024, Номер 25(3), С. 389 - 403
Опубликована: Фев. 14, 2024
Opinion statement Seizure activity is common in patients with primary and metastatic brain tumors, affecting more than 50% of cases over the course their disease. Several mechanisms contribute to tumor–related epilepsy (BTRE), including a pro-inflammatory environment, excessive secretion glutamate an increase neuronal excitatory tone, reduction GABAergic inhibitory activity, 2-hydroxygluturate production isocitrate dehydrogenase mutant tumors. After verified seizure tumor patient, consensus that BTRE has developed, it necessary initiate antiepileptic drug (AED). It not recommended AED prophylaxis. Second- third-generation AEDs are preferred options for initiation, due lack hepatic enzyme induction reduced likelihood drug-drug interactions, especially regard neoplastic treatment. The efficacy appropriate fairly equivalent, although some data suggests levetiracetam may be slightly active suppressing seizures other AEDs. among most Neuro-Oncology providers monotherapy after first as long patient does have any psychiatric co-morbidities. If tolerated well or ineffective, initial add-on anticonvulsant include lacosamide, valproic acid, briviracetam, lamotrigine, perampanel.
Язык: Английский