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肿瘤相关性癫痫:流行病学、发病机制与治疗。

Tumor-related epilepsy: epidemiology, pathogenesis and management.

机构信息

Department of Neuroscience, University of California, San Diego, USA.

Rady Children's Hospital San Diego, San Diego, USA.

出版信息

J Neurooncol. 2018 Aug;139(1):13-21. doi: 10.1007/s11060-018-2862-0. Epub 2018 May 24.

DOI:10.1007/s11060-018-2862-0
PMID:29797181
Abstract

INTRODUCTION

Seizure is a common comorbidity in patients with brain tumor. It may be the presenting symptom or develop after the tumor diagnosis. The underlying pathophysiology of brain tumor-related epilepsy remains poorly understood.

METHODS

A comprehensive literature review of Pubmed English articles from 1980-2017 was performed to summarize current knowledge and treatment options of brain tumor-related epilepsy.

RESULTS

Multiple factors have been found to contribute to tumor-related epilepsy, including tumor type, speed of tumor growth, location, and tumor burden. The underlying pathogenesis of epilepsy is not clear but perturbations in the peri-tumoral regions, both structural and cellular communications, have been implicated.

CONCLUSIONS

Surgical and medical treatments of tumor-related epilepsy remain challenging as additional factors such as the extent of surgical resection, interactions with tumor-related oncological treatments and anti-epileptic medication related side effects need to be considered.

摘要

简介

癫痫是脑肿瘤患者常见的共病。它可能是首发症状,也可能在肿瘤诊断后出现。脑肿瘤相关癫痫的潜在病理生理学仍不清楚。

方法

对 1980 年至 2017 年 Pubmed 英文文献进行全面文献复习,总结脑肿瘤相关癫痫的现有知识和治疗选择。

结果

已发现多种因素与肿瘤相关癫痫有关,包括肿瘤类型、肿瘤生长速度、位置和肿瘤负荷。癫痫的潜在发病机制尚不清楚,但涉及到肿瘤周围区域的结构和细胞通讯的改变。

结论

肿瘤相关癫痫的手术和药物治疗仍然具有挑战性,因为需要考虑其他因素,如手术切除的范围、与肿瘤相关的肿瘤治疗的相互作用以及抗癫痫药物的相关副作用。

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Tumor-related epilepsy: epidemiology, pathogenesis and management.肿瘤相关性癫痫:流行病学、发病机制与治疗。
J Neurooncol. 2018 Aug;139(1):13-21. doi: 10.1007/s11060-018-2862-0. Epub 2018 May 24.
2
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[Brain tumors and epilepsy].[脑肿瘤与癫痫]
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Epilepsy in patients with central nervous system tumors.中枢神经系统肿瘤患者的癫痫
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[Glioma-associated epilepsy].[胶质瘤相关性癫痫]
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Real-Time Monitoring of the Antiseizure Drug Valproic Acid Using a Novel Point-Of-Care Mass Spectrometry.使用新型即时护理质谱法对抗癫痫药物丙戊酸进行实时监测。
CNS Neurosci Ther. 2025 Jul;31(7):e70499. doi: 10.1111/cns.70499.
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Antiseizure medications for preventing a first seizure in adults with a brain tumour.用于预防脑肿瘤成人首次癫痫发作的抗癫痫药物。

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Efficacy and safety of Levetiracetam vs. other antiepileptic drugs in Hispanic patients with glioblastoma.左乙拉西坦与其他抗癫痫药物治疗 Hispanic 胶质母细胞瘤患者的疗效和安全性比较。
J Neurooncol. 2018 Jan;136(2):363-371. doi: 10.1007/s11060-017-2660-0. Epub 2017 Nov 25.
2
Lacosamide in patients with gliomas and uncontrolled seizures: results from an observational study.拉考沙胺治疗胶质瘤伴发癫痫发作控制不佳的患者:一项观察性研究的结果。
J Neurooncol. 2018 Jan;136(1):105-114. doi: 10.1007/s11060-017-2628-0. Epub 2017 Oct 13.
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Prophylactic anticonvulsants in patients with primary glioblastoma.
Cochrane Database Syst Rev. 2025 Jul 2;7(7):CD015155. doi: 10.1002/14651858.CD015155.
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Seizure outcomes in patients with brain metastases and epilepsy: a systematic review on the efficacy of antitumor treatment and antiseizure medication.脑转移瘤和癫痫患者的癫痫发作结局:关于抗肿瘤治疗和抗癫痫药物疗效的系统评价
Neurooncol Pract. 2024 Oct 22;12(3):376-388. doi: 10.1093/nop/npae103. eCollection 2025 Jun.
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Morphometric and radiomics analysis toward the prediction of epilepsy associated with supratentorial low-grade glioma in children.针对儿童幕上低级别胶质瘤相关癫痫预测的形态计量学和放射组学分析。
Cancer Imaging. 2025 May 19;25(1):63. doi: 10.1186/s40644-025-00881-1.
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Risk Factors and Prognostic Implications of Tumor-Related Epilepsy in Diffuse Glioma Patients: A Real-World Multicenter Study.弥漫性胶质瘤患者肿瘤相关性癫痫的危险因素及预后意义:一项真实世界多中心研究
Brain Behav. 2025 May;15(5):e70510. doi: 10.1002/brb3.70510.
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Mortality in patients with epilepsy: a systematic review.癫痫患者的死亡率:一项系统综述。
J Neurol. 2025 Mar 25;272(4):291. doi: 10.1007/s00415-025-13002-6.
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Antiepileptic drugs failed to prevent initial seizures or improve survival outcomes in patients with primary CNS lymphoma.抗癫痫药物未能预防原发性中枢神经系统淋巴瘤患者的初次发作,也未能改善其生存结局。
Sci Rep. 2025 Mar 23;15(1):10017. doi: 10.1038/s41598-025-94477-1.
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Transl Pediatr. 2025 Feb 28;14(2):329-337. doi: 10.21037/tp-24-306. Epub 2025 Feb 25.
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Comparative proteomic analysis of astrocytoma tissues from patients with and without seizures.有癫痫发作和无癫痫发作的星形细胞瘤患者组织的蛋白质组学比较分析。
Sci Rep. 2025 Jan 24;15(1):3020. doi: 10.1038/s41598-025-87525-3.
原发性神经胶质瘤患者的预防性抗癫痫药物。
J Neurooncol. 2017 Nov;135(2):229-235. doi: 10.1007/s11060-017-2584-8. Epub 2017 Jul 28.
4
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Neurosurgery. 2017 Aug 1;81(2):275-288. doi: 10.1093/neuros/nyw174.
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Epilepsy Res. 2016 Oct;126:185-96. doi: 10.1016/j.eplepsyres.2016.07.010. Epub 2016 Jul 27.