Related Experiment Video
Updated: Dec 29, 2025
Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Epilepsy in brain metastasis: an emerging entity
Roberta Rudà1, Francesca Mo2, Alessia Pellerino2
1Department of Neuro-Oncology, University and City of Health and Science Hospital, Via Cherasco 15, 10126, Turin, Italy. rudarob@hotmail.com.
Purpose Of Review:
The purpose of this review is to highlight advances in the management of seizures in brain metastases from solid tumors.
Recent Findings:
The highest risk for seizures is in patients with melanoma and lung cancer. There is lack of data on the efficacy of antiepileptic drugs (AEDs), but interactions between enzyme-inducing AEDs and anticancer agents must be avoided. Levetiracetam and valproic acid are the most appropriate drugs. Prophylaxis with AEDs for patients with brain metastases without a history of seizures is not recommended. Total resection of a brain metastasis allows complete seizure control. Seizures may represent an adverse effect of stereotactic radiosurgery or of high-dose chemotherapy. New preclinical and clinical studies should define the risk of brain metastasis in light of the new treatment options in the different tumor types. New clinical trials should be designed in patients with brain metastases in terms of treatment or prophylaxis of seizures.
Insights
Seizures in brain metastases are most common in melanoma and lung cancer patients. Antiepileptic drugs (AEDs) like levetiracetam and valproic acid are recommended, but prophylaxis is not advised for seizure-naive patients.
Area of Science:
- Neuro-oncology
- Clinical Neurology
- Pharmacology
Background:
- Brain metastases represent a significant challenge in solid tumor management.
- Seizures are a common neurological complication, impacting patient quality of life.
Purpose of the Study:
- To review recent advancements in managing seizures associated with brain metastases.
- To provide guidance on antiepileptic drug (AED) selection and use.
Main Methods:
- Literature review of preclinical and clinical studies on brain metastases and seizures.
- Analysis of current treatment strategies and drug efficacy data.
Main Results:
- Melanoma and lung cancer patients face the highest seizure risk.
- Levetiracetam and valproic acid are considered appropriate AEDs; enzyme-inducing AEDs should be avoided due to drug interactions.
- Surgical resection offers complete seizure control; prophylactic AEDs are not recommended for seizure-naive patients.
- Seizures can be an adverse effect of treatments like stereotactic radiosurgery or chemotherapy.
Conclusions:
- Further research is needed to clarify AED efficacy and optimize seizure management in brain metastases.
- Clinical trials should investigate optimal treatment and prophylaxis strategies for seizures in this patient population.
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:14Antiepileptic Drugs: Glutamate Antagonists