Brain Tumor Institute, Children's National Medical Center, Washington, DC, USA.
Semin Pediatr Neurol. 2012 Mar;19(1):3-8. doi: 10.1016/j.spen.2012.02.010.
Seizures are a common complication of pediatric brain tumors and their treatment. This article reviews the epidemiology, evaluation, and treatment of seizures in children with brain tumors. Seizures in known brain tumor patients may signify tumor progression or recurrence, or treatment-related brain damage, as well as other causes, including low drug levels and metabolic disturbances. Careful selection of antiepileptic medications is needed in this population. There are advantages to nonenzyme-inducing antiepileptic drugs including valproic acid, which has potential antitumoral properties as a histone deacetylase inhibitor. Tumor surgery cures many cases of pediatric tumor-associated seizures, and some children are controlled with anti-epileptic medication, however additional epilepsy surgery may be needed for refractory cases.
癫痫发作是儿童脑肿瘤及其治疗的常见并发症。本文回顾了儿童脑肿瘤患者癫痫发作的流行病学、评估和治疗。已知脑肿瘤患者的癫痫发作可能表明肿瘤进展或复发,或与治疗相关的脑损伤,以及其他原因,包括药物水平低和代谢紊乱。在这类人群中需要仔细选择抗癫痫药物。非酶诱导的抗癫痫药物具有优势,包括丙戊酸,它作为组蛋白去乙酰化酶抑制剂具有潜在的抗肿瘤特性。肿瘤手术治愈了许多与肿瘤相关的儿童癫痫发作,一些儿童通过抗癫痫药物得到控制,但对于难治性病例可能需要额外的癫痫手术。