Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios
Epilepsy represents a challenge in the management of patients with brain tumors. Epileptic seizures are one of the most frequent comorbidities in neuro-oncology and may be the debut symptom of a brain tumor or a complication during its evolution. Epileptogenic mechanisms of brain tumors are not yet...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.991244/full |
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| author | José Manuel Sánchez-Villalobos José Manuel Sánchez-Villalobos Ángel Aledo-Serrano Irene Villegas-Martínez Mohd Farooq Shaikh Miguel Alcaraz |
| author_facet | José Manuel Sánchez-Villalobos José Manuel Sánchez-Villalobos Ángel Aledo-Serrano Irene Villegas-Martínez Mohd Farooq Shaikh Miguel Alcaraz |
| author_sort | José Manuel Sánchez-Villalobos |
| collection | DOAJ |
| description | Epilepsy represents a challenge in the management of patients with brain tumors. Epileptic seizures are one of the most frequent comorbidities in neuro-oncology and may be the debut symptom of a brain tumor or a complication during its evolution. Epileptogenic mechanisms of brain tumors are not yet fully elucidated, although new factors related to the underlying pathophysiological process with possible treatment implications have been described. In recent years, the development of new anti-seizure medications (ASM), with better pharmacokinetic profiles and fewer side effects, has become a paradigm shift in many clinical scenarios in neuro-oncology, being able, for instance, to adapt epilepsy treatment to specific features of each patient. This is crucial in several situations, such as patients with cognitive/psychiatric comorbidity, pregnancy, or advanced age, among others. In this narrative review, we provide a rationale for decision-making in ASM choice for neuro-oncologic patients, highlighting the strengths and weaknesses of each drug. In addition, according to current literature evidence, we try to answer some of the most frequent questions that arise in daily clinical practice in patients with epilepsy related to brain tumors, such as, which patients are the best candidates for ASM and when to start it, what is the best treatment option for each patient, and what are the major pitfalls to be aware of during follow-up. |
| first_indexed | 2024-04-11T10:29:42Z |
| format | Article |
| id | doaj.art-caf986c165b045aa8a1f166d9a2f630f |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-11T10:29:42Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-caf986c165b045aa8a1f166d9a2f630f2022-12-22T04:29:28ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-10-011310.3389/fphar.2022.991244991244Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenariosJosé Manuel Sánchez-Villalobos0José Manuel Sánchez-Villalobos1Ángel Aledo-Serrano2Irene Villegas-Martínez3Mohd Farooq Shaikh4Miguel Alcaraz5Department of Neurology, University Hospital Complex of Cartagena, Murcia, SpainDepartment of Cell Biology and Histology, School of Medicine, Regional Campus of International Excellence, “Campus Mare Nostrum”, IMIB-Arrixaca, University of Murcia, Murcia, SpainEpilepsy Program, Department of Neurology, Ruber International Hospital, Madrid, SpainDepartment of Neurology, University Hospital Complex of Cartagena, Murcia, SpainNeuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, MalaysiaDepartment of Radiology and Physical Medicine, School of Medicine, Regional Campus of International Excellence, “Campus Mare Nostrum”, IMIB-Arrixaca, University of Murcia, Murcia, SpainEpilepsy represents a challenge in the management of patients with brain tumors. Epileptic seizures are one of the most frequent comorbidities in neuro-oncology and may be the debut symptom of a brain tumor or a complication during its evolution. Epileptogenic mechanisms of brain tumors are not yet fully elucidated, although new factors related to the underlying pathophysiological process with possible treatment implications have been described. In recent years, the development of new anti-seizure medications (ASM), with better pharmacokinetic profiles and fewer side effects, has become a paradigm shift in many clinical scenarios in neuro-oncology, being able, for instance, to adapt epilepsy treatment to specific features of each patient. This is crucial in several situations, such as patients with cognitive/psychiatric comorbidity, pregnancy, or advanced age, among others. In this narrative review, we provide a rationale for decision-making in ASM choice for neuro-oncologic patients, highlighting the strengths and weaknesses of each drug. In addition, according to current literature evidence, we try to answer some of the most frequent questions that arise in daily clinical practice in patients with epilepsy related to brain tumors, such as, which patients are the best candidates for ASM and when to start it, what is the best treatment option for each patient, and what are the major pitfalls to be aware of during follow-up.https://www.frontiersin.org/articles/10.3389/fphar.2022.991244/fullantiseizure medicationbrain tumorglial tumorseizuresodium channel blockersprecision medicine |
| spellingShingle | José Manuel Sánchez-Villalobos José Manuel Sánchez-Villalobos Ángel Aledo-Serrano Irene Villegas-Martínez Mohd Farooq Shaikh Miguel Alcaraz Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios Frontiers in Pharmacology antiseizure medication brain tumor glial tumor seizure sodium channel blockers precision medicine |
| title | Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios |
| title_full | Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios |
| title_fullStr | Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios |
| title_full_unstemmed | Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios |
| title_short | Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios |
| title_sort | epilepsy treatment in neuro oncology a rationale for drug choice in common clinical scenarios |
| topic | antiseizure medication brain tumor glial tumor seizure sodium channel blockers precision medicine |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.991244/full |
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