Retrospective analysis of the efficacy and tolerability of levetiracetam in brain tumor patients

Seizures are a common complication of primary (PBT) and metastatic (MBT) brain tumors, affecting approximately 50% of all patients during the course of their illness. Anti-convulsant therapy of these tumor-induced seizures is often inadequate with conventional anti-epileptic drugs (AEDs), due to a v...

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Bibliographic Details
Published in:Journal of neuro-oncology 2006-05, Vol.78 (1), p.99-102
Main Authors: NEWTON, Herbert B, GOLDLUST, Samuel A, PEARL, Dennis
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anticonvulsants - therapeutic use
Biological and medical sciences
Brain Neoplasms - complications
Female
Humans
Injuries of the nervous system and the skull. Diseases due to physical agents
Male
Medical sciences
Middle Aged
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
Piracetam - analogs & derivatives
Piracetam - therapeutic use
Retrospective Studies
Seizures - drug therapy
Seizures - etiology
Traumas. Diseases due to physical agents
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Summary:Seizures are a common complication of primary (PBT) and metastatic (MBT) brain tumors, affecting approximately 50% of all patients during the course of their illness. Anti-convulsant therapy of these tumor-induced seizures is often inadequate with conventional anti-epileptic drugs (AEDs), due to a variety of factors, including activation of glutaminergic NMDA receptors, immune-mediated neuronal damage, and anatomic alterations of neuronal input pathways. Levetiracetam (LEV) is a new AED with a novel mechanism of action, which includes reducing the Ca++ current through neuron-specific, high voltage activated Ca++ channels (n-type). Because of this unique mechanism, it has been postulated that LEV may be effective in controlling tumor-induced seizures. A retrospective chart review was performed of all patients who had received LEV for seizure control. Forty-one patients were reviewed (22 female, 19 male), with a median age of 47.5 years (range 25-81). There were 34 patients with PBT and 7 with MBT. LEV was used as an add-on AED in 33 patients and as monotherapy in eight patients, with a median dose of 1500 mg/day (range 500-3500). The baseline median seizure frequency for the cohort was 1 per week. After the addition of LEV and follow-up for a minimum of 4 weeks, the median seizure frequency was reduced to 0 per week (59% of patients noted complete seizure control). Overall, the seizure frequency was reduced in 90% of patients (P
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-005-9070-4