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BMC Neurology
Published in: BMC Neurology 1/2022

Open Access 01-12-2022 | Brain Tumor | Research

Perioperative levetiracetam for seizure prophylaxis in seizure-naive brain tumor patients with focus on neurocognitive functioning

Authors: Elias Konrath, Franz Marhold, Wolfgang Kindler, Florian Scheichel, Branko Popadic, Katrin Blauensteiner, Bernadette Calabek, Elisabeth Freydl, Michael Weber, Robin Ristl, Katharina Hainz, Camillo Sherif, Stefan Oberndorfer

Published in: BMC Neurology | Issue 1/2022

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Abstract

Introduction

In seizure-naive brain tumor patients, the efficacy of perioperative prophylactic antiepileptic drug treatment remains controversial. In case of administration, the common preferred drug is levetiracetam (LEV) because of its favorable pharmacological profile. Research to date has not sufficiently determined how LEV affects cognition in the short term, as is the case in the perioperative period. The objective of this prospective study was to examine the neurocognitive functioning of seizure-naive brain tumor patients after receiving LEV perioperatively.

Methods

Fortythree patients with supratentorial brain tumor scheduled for surgery received LEV three days before until six days after surgery as seizure prophylaxis. Cognitive functioning (NeuroCogFX), LEV plasma-levels, hematotoxicity, side-effects, as well as health-related quality of life (HRQoL, Qolie31), were recorded preoperatively before (Baseline) and after onset of LEV (Pre-Op), 4–6 days postoperatively (Post-Op) and 21 days postoperatively (Follow-Up).

Results

No significant changes in cognitive functioning and HRQoL were seen after onset of preoperative LEV. There was a significant improvement of NeuroCogFX total-score at Follow-Up (p = 0.004) compared to Baseline. The overall-score Qolie31 showed simultaneous improvement patterns as cognitive functioning (p < 0.001). The most frequent side effect related to study drug was somnolence (in 28.6% of patients).

Conclusions

A significant improvement of cognitive functioning, as well as an improvement in HRQoL, were detected postoperatively. This is presumably due to the debulking effect of the surgery. Nevertheless, LEV has no detrimental effect on cognitive functioning in the perioperative phase in seizure-naive brain tumor patients.

Trial registration

This study was registered prospectively (Date: 25/11/2015; EudraCT: 2015–003,916-19).
Appendix
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Metadata
Title
Perioperative levetiracetam for seizure prophylaxis in seizure-naive brain tumor patients with focus on neurocognitive functioning
Authors
Elias Konrath
Franz Marhold
Wolfgang Kindler
Florian Scheichel
Branko Popadic
Katrin Blauensteiner
Bernadette Calabek
Elisabeth Freydl
Michael Weber
Robin Ristl
Katharina Hainz
Camillo Sherif
Stefan Oberndorfer
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-022-02762-7

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