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Epilepsy in patients with brain tumors and other cancers

Edward B Bromfield1

  • 1Division of Epilepsy and EEG, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Reviews in Neurological Diseases
|January 10, 2006
PubMed

Insights

Epilepsy frequently affects patients with brain tumors, particularly supratentorial ones. Newer antiepileptic drugs offer improved safety profiles, though surgical intervention may be necessary for optimal seizure control.

Area of Science:

  • Neurology
  • Oncology

Background:

  • Epilepsy is a common complication in patients with supratentorial tumors, especially slow-growing types.
  • Systemic cancer can lead to epilepsy through parenchymal or leptomeningeal metastases.
  • Acute symptomatic seizures can arise from reversible medical and neurological disturbances.

Purpose of the Study:

  • To summarize the relationship between brain tumors and epilepsy.
  • To highlight current therapeutic strategies for managing epilepsy in cancer patients.

Main Methods:

  • Review of current literature on epilepsy associated with brain tumors.
  • Analysis of newer antiepileptic drug (AED) efficacy and side effect profiles.
  • Discussion of surgical interventions for intractable epilepsy.

Main Results:

  • Supratentorial tumors are a significant cause of epilepsy.
  • Newer AEDs demonstrate improved tolerability and fewer drug interactions compared to older agents.
  • Complete tumor resection, potentially including the epileptogenic zone, may be required for seizure control.

Conclusions:

  • Epilepsy management in brain tumor patients requires a multidisciplinary approach.
  • Tailored treatment strategies, including pharmacotherapy and surgery, are crucial for effective seizure control.
  • Understanding the mechanisms of seizure induction by metastases is vital for managing acute symptomatic seizures.

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