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Brain tumor related-epilepsy
Affiliations- Department of Neurology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville
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Abstract
Gliomas are commonly associated with the development of epilepsy; in some cases the two conditions share common pathogenic mechanisms and may influence each other. Brain tumor related-epilepsy (BTRE) complicates the clinical management of gliomas and can substantially affect daily life.
State of the artThe incidence of seizures is high in patients with slow growing tumors located in the frontotemporal regions. However, recent studies suggest that epileptogenesis may be more associated with tumor molecular genetic markers than tumor grade or location. Although the exact mechanism of epileptogenesis in glioma is incompletely understood, glutamate-induced excitotoxicity and disruption of intracellular communication have garnered the most attention.
Clinical managementManagement of BTRE requires a multidisciplinary approach involving the use of antiepileptic drugs (AEDs), surgery aided by electrocorticography, and adjuvant chemoradiation.
Future directionsInsight into the mechanisms of glioma growth and epileptogenesis is essential to identify new treatment targets and to develop effective treatment for both conditions. Selecting AEDs tailored to act against known tumor molecular markers involved in the epileptogenesis could enhance treatment value and help inform individualized medicine in BRTE.
Abstract
Gliomas are commonly associated with the development of epilepsy; in some cases the two conditions share common pathogenic mechanisms and may influence each other. Brain tumor related-epilepsy (BTRE) complicates the clinical management of gliomas and can substantially affect daily life.
State of the artThe incidence of seizures is high in patients with slow growing tumors located in the frontotemporal regions. However, recent studies suggest that epileptogenesis may be more associated with tumor molecular genetic markers than tumor grade or location. Although the exact mechanism of epileptogenesis in glioma is incompletely understood, glutamate-induced excitotoxicity and disruption of intracellular communication have garnered the most attention.
Clinical managementManagement of BTRE requires a multidisciplinary approach involving the use of antiepileptic drugs (AEDs), surgery aided by electrocorticography, and adjuvant chemoradiation.
Future directionsInsight into the mechanisms of glioma growth and epileptogenesis is essential to identify new treatment targets and to develop effective treatment for both conditions. Selecting AEDs tailored to act against known tumor molecular markers involved in the epileptogenesis could enhance treatment value and help inform individualized medicine in BRTE.
Keywords
Antiepileptic drugs, Epileptogensis, Glioma, IDH1 mutation, Tumors markers
About this articleTitle
Brain tumor related-epilepsy
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
436-447
Published online
2018-06-30
Page views
281
Article views/downloads
1475
DOI
10.1016/j.pjnns.2018.06.001
Bibliographic record
Neurol Neurochir Pol 2018;52(4):436-447.
Keywords
Antiepileptic drugs
Epileptogensis
Glioma
IDH1 mutation
Tumors markers
Authors
Eric D. Goldstein
Anteneh M. Feyissa
