Abstract
Symptomatic epilepsy is frequently encountered in patients with brain metastases (BM), affecting up to 25% of them. However, it generally remains unknown whether the risk of seizures in such cases is affected by stereotactic radiosurgery (SRS), which involves highly conformal delivery of high-dose irradiation to the tumor with a minimal effect on adjacent brain tissue. Thus, the role of prophylactic administration of antiepileptic drugs (AED) after SRS remains controversial. A comprehensive review and analysis of the available literature reveals that according to prospective studies, the incidence of seizures after SRS for BM varies from 8% to 22%, and there is no evidence that SRS increases the incidence of symptomatic epilepsy. Therefore, routine prophylactic administration of AED prior to, during, or after SRS in the absence of a seizure history is not recommended. Nevertheless, short-course administration of an AED may be judiciously considered (on the basis of class III evidence) for selected high-risk individuals.
Original language | English (US) |
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Title of host publication | Acta Neurochirurgica, Supplementum |
Publisher | Springer Science and Business Media Deutschland GmbH |
Pages | 51-55 |
Number of pages | 5 |
DOIs | |
State | Published - 2021 |
Publication series
Name | Acta neurochirurgica. Supplement |
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Publisher | Springer Wien |
ISSN (Print) | 0065-1419 |
Bibliographical note
Publisher Copyright:© 2021, Springer Nature Switzerland AG.
Keywords
- Antiepileptic drugs
- Fractionated radiotherapy
- Intracranial metastases
- Prophylactic antiepileptic therapy
- Seizures
- Stereotactic radiosurgery
- Symptomatic epilepsy
- Prospective Studies
- Humans
- Brain Neoplasms/surgery
- Radiosurgery
- Seizures/etiology
- Retrospective Studies
PubMed: MeSH publication types
- Review
- Journal Article