Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
Lancet Oncol. 2012 Sep;13(9):e375-82. doi: 10.1016/S1470-2045(12)70266-8.
The lifetime risk of having epileptic seizures is profoundly increased in patients with cancer: about 20% of all patients with systemic cancer may develop brain metastases. These patients and those with primary brain tumours have a lifetime risk of epilepsy of 20-80%. Moreover, exposure to chemotherapy or radiotherapy to the brain, cancer-related metabolic disturbances, stroke, and infection can provoke seizures. The management of epilepsy in patients with cancer includes diagnosis and treatment of the underlying cerebral pathological changes, secondary prophylaxis with antiepileptic drugs, and limiting of the effect of epilepsy and its treatment on the efficacy and tolerability of anticancer treatments, cognitive function, and quality of life. Because of the concern of drug-drug interactions, the pharmacological approach to epilepsy requires a multidisciplinary approach, specifically in a setting of rapidly increasing choices of agents both to treat cancer and cancer-associated epilepsy.
约 20%的全身癌症患者可能发展为脑转移。这些患者和原发性脑肿瘤患者癫痫的终身风险为 20-80%。此外，脑部放化疗、癌症相关代谢紊乱、中风和感染都可能引发癫痫发作。癌症患者癫痫的治疗包括诊断和治疗潜在的脑部病理变化、使用抗癫痫药物进行二级预防，以及限制癫痫及其治疗对癌症治疗效果和耐受性、认知功能和生活质量的影响。由于担心药物相互作用，癫痫的药理学治疗方法需要多学科方法，特别是在癌症和癌症相关癫痫的治疗药物选择快速增加的情况下。
