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Review
. 2016:134:267-85.
doi: 10.1016/B978-0-12-802997-8.00016-5.

Epilepsy and brain tumors

Dario J Englot  1 , Edward F Chang  1 , Charles J Vecht  2
Affiliations
Review

Epilepsy and brain tumors

Dario J Englot et al. Handb Clin Neurol. 2016.

Abstract

Seizures are common in patients with brain tumors, and epilepsy can significantly impact patient quality of life. Therefore, a thorough understanding of rates and predictors of seizures, and the likelihood of seizure freedom after resection, is critical in the treatment of brain tumors. Among all tumor types, seizures are most common with glioneuronal tumors (70-80%), particularly in patients with frontotemporal or insular lesions. Seizures are also common in individuals with glioma, with the highest rates of epilepsy (60-75%) observed in patients with low-grade gliomas located in superficial cortical or insular regions. Approximately 20-50% of patients with meningioma and 20-35% of those with brain metastases also suffer from seizures. After tumor resection, approximately 60-90% are rendered seizure-free, with most favorable seizure outcomes seen in individuals with glioneuronal tumors. Gross total resection, earlier surgical therapy, and a lack of generalized seizures are common predictors of a favorable seizure outcome. With regard to anticonvulsant medication selection, evidence-based guidelines for the treatment of focal epilepsy should be followed, and individual patient factors should also be considered, including patient age, sex, organ dysfunction, comorbidity, or cotherapy. As concomitant chemotherapy commonly forms an essential part of glioma treatment, enzyme-inducing anticonvulsants should be avoided when possible. Seizure freedom is the ultimate goal in the treatment of brain tumor patients with epilepsy, given the adverse effects of seizures on quality of life.

Keywords: anticonvulsant; epilepsy; glioma; glioneuronal tumor; meningioma; metastasis; outcome; seizure.

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Figures

Fig. 16.1
Fig. 16.1
Summed statistic image demonstrating aggregate location of 124 tumors. At each voxel, the number of patients presenting with tumors is calculated. Maps are generated from the sum of the binary tumor masks for high-grade (A) and low-grade (B) gliomas. (Reproduced with permission from Lee et al., 2010, © American Medical Association. All rights reserved.)
See this image and copyright information in PMC

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