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Current Neurology and Neuroscience Reports

Published in:

17-07-2024 | Epilepsy | Review

Patient-Centered Management of Brain Tumor-Related Epilepsy

Authors: Maria Kristina C. Dorotan, Steven Tobochnik

Published in: Current Neurology and Neuroscience Reports | Issue 9/2024

Abstract

Purpose of Review

Brain tumor-related epilepsy is a heterogenous syndrome involving variability in incidence, timing, pathophysiology, and clinical risk factors for seizures across different brain tumor pathologies. Seizure risk and disability are dynamic over the course of disease and influenced by tumor-directed treatments, necessitating individualized patient-centered management strategies to optimize quality of life.

Recent Findings

Recent translational findings in diffuse gliomas indicate a dynamic bidirectional relationship between glioma growth and hyperexcitability. Certain non-invasive measures of hyperexcitability are correlated with survival outcomes, however it remains uncertain how to define and measure clinically relevant hyperexcitability serially over time. The extent of resection, timing of pre-operative and/or post-operative seizures, and the likelihood of tumor progression are critical factors impacting the risk of seizure recurrence. Newer anti-seizure medications are generally well-tolerated with similar efficacy in this population, and several rapid-onset seizure rescue agents are in development and available.

Summary

Seizures in patients with brain tumors are strongly influenced by the underlying tumor biology and treatment. An improved understanding of the interactions between tumor cells and the spectrum of hyperexcitability will facilitate targeted therapies. Multidisciplinary management of seizures should occur with consideration of tumor-directed therapy and prognosis, and anti-seizure medication decision-making tailored to the individual priorities and quality of life of the patient.

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Title: Patient-Centered Management of Brain Tumor-Related Epilepsy
Authors: Maria Kristina C. Dorotan
Steven Tobochnik
Publication date: 17-07-2024
Publisher: Springer US
Keywords: Epilepsy
Brain Tumor
Glioma
Glioma
Glioma
Electroencephalography
Levetiracetam
Perampanel
Published in: Current Neurology and Neuroscience Reports / Issue 9/2024
Print ISSN: 1528-4042
Electronic ISSN: 1534-6293
DOI: https://doi.org/10.1007/s11910-024-01360-z

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