Pharmacotherapy of epileptic seizures in glioma patients: who, when, why and how long?

BACKGROUND

The risk for patients with primary brain tumors of experiencing an epileptic seizure at least once in the course of disease probably exceeds 50%, depending on tumor location and tumor type. Several aspects regarding the role of anticonvulsants in the treatment of brain tumor patients have remained controversial.

METHODS

We reviewed the seizure history in 107 patients undergoing a surgical procedure for glioma at our institution.

RESULTS

The overall seizure incidence was 68%. Pre-operative seizures did not predict the occurrence of post-operative seizures. After surgery, postoperative chemo- or radiotherapy and anticonvulsive therapy one third of patients was seizure-free whereas one third showed frequent seizures despite this treatment. Seizure frequency increased regardless of anticonvulsive treatment with progressive or recurrent tumor growth.

CONCLUSIONS

Based on a literature review and our institutional experience, we delineate some recommendations for the management of seizures in patients with brain tumors.