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Should Patient Have Antiepileptic treatment?

Should Patient Have Antiepileptic treatment?. Tumor-induced seizures. Usually have a focal onset then become generalized Respond to standard anticonvulsant medications

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Should Patient Have Antiepileptic treatment?

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  1. Should Patient Have Antiepileptic treatment?

  2. Tumor-induced seizures • Usually have a focal onset then become generalized • Respond to standard anticonvulsant medications • Symptomatic epilepsy should be treated with anticonvulsants, if possibly starting after the first seizure. (Kaal et al, 2008)

  3. The use of the ‘classic’ anticonvulsants carbamazepine, phenytoin and phenobarbital in patients receiving concomitant chemotherapy or dexamethasone may lead to insufficient tumour control. • enzyme-inducing effects on isoenzymes of the hepatic cytochrome P450 system, • Valproic Acid • the preferred anticonvulsant in patients with epilepsy and brain tumours because of effectiveness and relatively good tolerability • enzyme-inhibitor • may cause enhanced toxicity due to impaired metabolism of concomitant administered chemotherapeutic drugs. (Kaal et al, 2008)

  4. Seizure Prophylaxis • There was no difference between the treatment interventions and the control groups in preventing a first seizure in patients with brain tumors. • The risk of an adverse event was higher for those on antiepileptic drugs than for participants not on antiepileptic drugs (NNH 3; RR 6.10, 95% CI 1.10 to 34.63; P = 0.046). • (Tremont-Lukats et al, 2008)

  5. Tremont-Lukats IW, Ratilal BO, Armstrong T, Gilbert MR. Antiepileptic drugs for preventing seizures in people with brain tumors. Cochrane Database of Systematic Reviews 2008, Issue 2. • Kaal EC, Martin J.B. Taphoorn and Charles J. VechtSymptomaticmanagement and imaging of brain metastases. Journal of Neuro-Oncology (2005) 75: 15–20

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