Sperling Michael R, Ko James
Department of Neurology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Semin Oncol. 2006 Jun;33(3):333-41. doi: 10.1053/j.seminoncol.2006.03.009.
Seizures commonly occur in people with brain tumors. They may be the presenting symptom of a brain tumor, or develop some time after tumor diagnosis. The risk of seizures is greatest when the tumors have a central location, slow growth rate, and when multiple lesions are present. Interactions between anti-epileptic drugs (AEDs), chemotherapeutic agents, and corticosteroids increase the complexity and challenge in managing seizures, and drugs that do not interfere with the cytochrome P-450 enzyme complex and have low protein binding may be preferable. The comparative efficacy and side effects of the various AEDs are not established in brain tumors, so drug choice relies on both the theoretical advantages of pharmacokinetic properties and clinical judgment. Prophylactic anticonvulsant treatment is not advisable in brain tumor patients who have not experienced seizures.
癫痫发作在脑肿瘤患者中很常见。它们可能是脑肿瘤的首发症状，或者在肿瘤诊断后的一段时间内出现。当肿瘤位于中枢、生长缓慢且存在多个病灶时，癫痫发作的风险最大。抗癫痫药物（AEDs）、化疗药物和皮质类固醇之间的相互作用增加了癫痫管理的复杂性和挑战性，不干扰细胞色素P-450酶复合物且蛋白结合率低的药物可能更可取。各种AEDs在脑肿瘤中的比较疗效和副作用尚未明确，因此药物选择既依赖于药代动力学特性的理论优势，也依赖于临床判断。对于未经历过癫痫发作的脑肿瘤患者，不建议进行预防性抗惊厥治疗。
