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Fortschritte der Neurologie Psychiatrie 2014-Dec

[Anticonvulsant therapy for brain tumour-related epilepsy].

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W Fröscher
T Kirschstein
J Rösche

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The lifetime risk of patients with brain tumours to have focal epileptic seizures is 20-80%. Based on current evidence the management of tumour-related seizures does not differ substantially from that applied to epilepsies from other aetiologies. Therefore, the choice of an anticonvulsant is based, above all, on tolerability and pharmacokinetic interactions with chemotherapeutic drugs. Levetiracetam is recommended by many authors as first-line therapy in brain tumour-related epilepsy; this corresponds with the recommendation of the German guidelines on the treatment of focal seizures of any aetiology. Based on current evidence, the prophylactic prescription of long-term antiepileptic drugs in brain tumour patients who have not presented with seizures is not justified. Because of the high risk of recurrence, however, antiepileptic treatment should be strongly considered after a single brain tumour-related seizure.

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