Epilepsy in Patients with Cerebral Radiation Necrosis: A Scoping Review

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Cerebral radiation necrosis (CRN) is a delayed complication of radiation therapy (RT).
• CRN can be asymptomatic or symptomatic (sCRN), with epilepsy being a severe manifestation of sCRN.
• A knowledge gap exists regarding CRN-induced epilepsy.

Purpose of the Study:

• To provide a comprehensive overview of the literature on CRN-induced epilepsy.
• To explore its prevalence, potential risk factors, and treatment options.

Main Methods:

• A scoping review was conducted following PRISMA guidelines.
• Searches were performed in PubMed and Embase databases.
• Relevant clinical studies on CRN-induced epilepsy were identified.

Main Results:

• Twenty-four studies were identified, with epilepsy as a primary outcome in only three.
• Epilepsy was an exploratory outcome or part of case series in the remaining studies.
• Significant heterogeneity existed regarding tumor types, CRN definitions, and RT practices.

Conclusions:

• Epilepsy is a significant clinical symptom in patients with sCRN.
• The current literature is insufficient to draw firm conclusions on prevalence, risk factors, or management.
• Future research must prioritize evaluating treatment strategies for seizure control in sCRN.