Abstract
Brain tumours are relatively uncommon, but family physicians are sometimes confronted with the somewhat unnerving task of carrying on the day-to-day management of these patients. The authors examine some of the problems encountered in preventing seizures among brain tumour patients. Using illustrative clinical cases and a review of the relevant literature, guidelines are provided for the institution, maintenance, and in some cases discontinuation of seizure prophylaxis for this group of patients.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Arts W. F., Visser L. H., Loonen M. C., Tjiam A. T., Stroink H., Stuurman P. M., Poortvliet D. C. Follow-up of 146 children with epilepsy after withdrawal of antiepileptic therapy. Epilepsia. 1988 May-Jun;29(3):244–250. doi: 10.1111/j.1528-1157.1988.tb03713.x. [DOI] [PubMed] [Google Scholar]
- Bouma P. A., Peters A. C., Arts R. J., Stijnen T., Van Rossum J. Discontinuation of antiepileptic therapy: a prospective study in children. J Neurol Neurosurg Psychiatry. 1987 Dec;50(12):1579–1583. doi: 10.1136/jnnp.50.12.1579. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cabral R. J., King T. T., Scott D. F. Epilepsy after two different neurosurgical approaches to the treatment of ruptured intracranial aneurysm. J Neurol Neurosurg Psychiatry. 1976 Nov;39(11):1052–1056. doi: 10.1136/jnnp.39.11.1052. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cabral R., King T. T., Scott D. F. Incidence of postoperative epilepsy after a transtentorial approach to acoustic nerve tumours. J Neurol Neurosurg Psychiatry. 1976 Jul;39(7):663–665. doi: 10.1136/jnnp.39.7.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Callaghan N., Garrett A., Goggin T. Withdrawal of anticonvulsant drugs in patients free of seizures for two years. A prospective study. N Engl J Med. 1988 Apr 14;318(15):942–946. doi: 10.1056/NEJM198804143181502. [DOI] [PubMed] [Google Scholar]
- Chalk J. B., Ridgeway K., Brophy T., Yelland J. D., Eadie M. J. Phenytoin impairs the bioavailability of dexamethasone in neurological and neurosurgical patients. J Neurol Neurosurg Psychiatry. 1984 Oct;47(10):1087–1090. doi: 10.1136/jnnp.47.10.1087. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cohen N., Strauss G., Lew R., Silver D., Recht L. Should prophylactic anticonvulsants be administered to patients with newly-diagnosed cerebral metastases? A retrospective analysis. J Clin Oncol. 1988 Oct;6(10):1621–1624. doi: 10.1200/JCO.1988.6.10.1621. [DOI] [PubMed] [Google Scholar]
- Delattre J. Y., Safai B., Posner J. B. Erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and phenytoin. Neurology. 1988 Feb;38(2):194–198. doi: 10.1212/wnl.38.2.194. [DOI] [PubMed] [Google Scholar]
- Deutschman C. S., Haines S. J. Anticonvulsant prophylaxis in neurological surgery. Neurosurgery. 1985 Sep;17(3):510–517. doi: 10.1227/00006123-198509000-00021. [DOI] [PubMed] [Google Scholar]
- Emerson R., D'Souza B. J., Vining E. P., Holden K. R., Mellits E. D., Freeman J. M. Stopping medication in children with epilepsy: predictors of outcome. N Engl J Med. 1981 May 7;304(19):1125–1129. doi: 10.1056/NEJM198105073041902. [DOI] [PubMed] [Google Scholar]
- Gillham R. A., Williams N., Wiedmann K., Butler E., Larkin J. G., Brodie M. J. Concentration-effect relationships with carbamazepine and its epoxide on psychomotor and cognitive function in epileptic patients. J Neurol Neurosurg Psychiatry. 1988 Jul;51(7):929–933. doi: 10.1136/jnnp.51.7.929. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Holowach J., Thurston D. L., O'Leary J. Prognosis in childhood epilepsy. Follow-up study of 148 cases in which therapy had been suspended after prolonged anticonvulsant control. N Engl J Med. 1972 Jan 27;286(4):169–174. doi: 10.1056/NEJM197201272860401. [DOI] [PubMed] [Google Scholar]
- Kikuchi K., McCormick C. I., Neuwelt E. A. Immunosuppression by phenytoin: implication for altered immune competence in brain-tumor patients. J Neurosurg. 1984 Dec;61(6):1085–1090. doi: 10.3171/jns.1984.61.6.1085. [DOI] [PubMed] [Google Scholar]
- Kvam D. A., Loftus C. M., Copeland B., Quest D. O. Seizures during the immediate postoperative period. Neurosurgery. 1983 Jan;12(1):14–17. doi: 10.1227/00006123-198301000-00003. [DOI] [PubMed] [Google Scholar]
- Lee S. T., Lui T. N., Chang C. N., Cheng W. C., Wang D. J., Heimburger R. F., Lin C. G. Prophylactic anticonvulsants for prevention of immediate and early postcraniotomy seizures. Surg Neurol. 1989 May;31(5):361–364. doi: 10.1016/0090-3019(89)90067-0. [DOI] [PubMed] [Google Scholar]
- Matthew E., Sherwin A. L., Welner S. A., Odusote K., Stratford J. G. Seizures following intracranial surgery: incidence in the first post-operative week. Can J Neurol Sci. 1980 Nov;7(4):285–290. doi: 10.1017/s0317167100022757. [DOI] [PubMed] [Google Scholar]
- North J. B., Penhall R. K., Hanieh A., Frewin D. B., Taylor W. B. Phenytoin and postoperative epilepsy. A double-blind study. J Neurosurg. 1983 May;58(5):672–677. doi: 10.3171/jns.1983.58.5.0672. [DOI] [PubMed] [Google Scholar]
- North J. B., Penhall R. K., Hanieh A., Hann C. S., Challen R. G., Frewin D. B. Postoperative epilepsy: a double-blind trial of phenytoin after craniotomy. Lancet. 1980 Feb 23;1(8165):384–386. doi: 10.1016/s0140-6736(80)90941-1. [DOI] [PubMed] [Google Scholar]
- Olanow C. W., Finn A. L. Phenytoin: pharmacokinetics and clinical therapeutics. Neurosurgery. 1981 Jan;8(1):112–117. doi: 10.1227/00006123-198101000-00022. [DOI] [PubMed] [Google Scholar]
- Pedley T. A. Discontinuing antiepileptic drugs. N Engl J Med. 1988 Apr 14;318(15):982–984. doi: 10.1056/NEJM198804143181508. [DOI] [PubMed] [Google Scholar]
- Ramamurthi B., Ravi B., Ramachandran V. Convulsions with meningiomas: incidence and significance. Surg Neurol. 1980 Dec;14(6):415–416. [PubMed] [Google Scholar]
- Thurston J. H., Thurston D. L., Hixon B. B., Keller A. J. Prognosis in childhood epilepsy: additional follow-up of 148 children 15 to 23 years after withdrawal of anticonvulsant therapy. N Engl J Med. 1982 Apr 8;306(14):831–836. doi: 10.1056/NEJM198204083061403. [DOI] [PubMed] [Google Scholar]
- Todt H. The late prognosis of epilepsy in childhood: results of a prospective follow-up study. Epilepsia. 1984 Apr;25(2):137–144. doi: 10.1111/j.1528-1157.1984.tb04169.x. [DOI] [PubMed] [Google Scholar]
- Woo E., Chan Y. M., Yu Y. L., Chan Y. W., Huang C. Y. If a well-stabilized epileptic patient has a subtherapeutic antiepileptic drug level, should the dose be increased? A randomized prospective study. Epilepsia. 1988 Mar-Apr;29(2):129–139. doi: 10.1111/j.1528-1157.1988.tb04408.x. [DOI] [PubMed] [Google Scholar]