Seizures and epilepsy in cancer patients

Seizures in the general population may occur for a variety of reasons, including vascular, infectious, autoimmune, genetic, and traumatic causes. In the cancer population, seizures arise mainly as a result of an infiltrative neoplastic process in the brain. However, seizures as a result of cancer treatment, metabolic causes, or paraneoplastic diseases may occur in patients with systemic cancer, even in the absence of a cerebral lesion. The etiology of seizures in brain tumor patients includes primary cerebral neoplasms and metastatic brain lesions. The treatment for seizures in this population is multifaceted and involves surgery, radiation, chemotherapy, and antiepileptic drugs. All treatments have potential adverse effects, especially when combined. The treatment for brain tumor-associated seizures and epilepsy almost always is geared toward treating the tumor, but subsequent treatment of seizures often is necessary. A pragmatic approach to this problem is essential to mitigate potential complications from treatment.