脑肿瘤患者的癫痫管理和预防措施考虑。
Seizure Management and Prophylaxis Considerations in Patients with Brain Tumors.
机构信息
Department of Neurology, Haukeland University Hospital, Jonas Lies Vei 65, 5021, Bergen, Norway.
出版信息
Curr Oncol Rep. 2023 Jul;25(7):787-792. doi: 10.1007/s11912-023-01410-8. Epub 2023 Apr 18.
Abstract
PURPOSE OF REVIEW
The article gives an overview of the current knowledge in the management of tumor related epilepsy, including systematic reviews and consensus statements as well as recent insight into a potentially more individualized treatment approach.
RECENT FINDINGS
Tumor molecular markers as IDH1 mutation and MGMT methylation status may provide future treatment targets. Seizure control should be included as a metric in assessing efficacy of tumor treatment. Prophylactic treatment is recommended in all brain tumor patients after the first seizure. Epilepsy has a profound effect on the quality of life in this patient group. The clinician should tailor the choice of seizure prophylactic treatment to the individual patient, with the goal of limiting adverse effects, avoiding interactions and obtaining a high degree of seizure freedom. Status epilepticus is associated with inferior survival and must be treated promptly. A multidisciplinary team should treat patients with brain tumors and epilepsy.
摘要
目的综述
本文概述了肿瘤相关性癫痫的治疗现状，包括系统评价和共识声明，以及最近对潜在更个体化治疗方法的深入了解。
最近的发现
肿瘤分子标志物，如 IDH1 突变和 MGMT 甲基化状态，可能为未来的治疗提供靶点。在评估肿瘤治疗效果时，应将癫痫发作控制作为一个指标。所有脑肿瘤患者在首次癫痫发作后均应进行预防性治疗。癫痫对该患者群体的生活质量有深远影响。临床医生应根据个体患者的情况选择合适的预防癫痫发作的治疗方法，以限制不良反应、避免相互作用并获得高度的无癫痫发作状态。癫痫持续状态与生存率降低有关，必须及时治疗。多学科团队应治疗患有脑肿瘤和癫痫的患者。
相似文献
1
Seizure Management and Prophylaxis Considerations in Patients with Brain Tumors.脑肿瘤患者的癫痫管理和预防措施考虑。
Curr Oncol Rep. 2023 Jul;25(7):787-792. doi: 10.1007/s11912-023-01410-8. Epub 2023 Apr 18.
2
IDH1 and IDH2 mutations in postoperative diffuse glioma-associated epilepsy.术后弥漫性胶质瘤相关性癫痫中的异柠檬酸脱氢酶1和异柠檬酸脱氢酶2突变
Epilepsy Behav. 2018 Jan;78:30-36. doi: 10.1016/j.yebeh.2017.10.027. Epub 2017 Dec 22.
3
Seizure control as a new metric in assessing efficacy of tumor treatment in low-grade glioma trials.癫痫控制作为评估低级别胶质瘤试验中肿瘤治疗疗效的一项新指标。
Neuro Oncol. 2017 Jan;19(1):12-21. doi: 10.1093/neuonc/now190. Epub 2016 Sep 20.
4
Potential influence of IDH1 mutation and MGMT gene promoter methylation on glioma-related preoperative seizures and postoperative seizure control.IDH1 突变和 MGMT 基因启动子甲基化对胶质瘤相关术前发作和术后发作控制的潜在影响。
Seizure. 2019 Jul;69:283-289. doi: 10.1016/j.seizure.2019.05.018. Epub 2019 May 20.
5
IDH1 mutation is associated with a higher preoperative seizure incidence in low-grade glioma: A systematic review and meta-analysis.异柠檬酸脱氢酶1（IDH1）突变与低级别胶质瘤术前癫痫发作发生率较高相关：一项系统评价和荟萃分析。
Seizure. 2018 Feb;55:76-82. doi: 10.1016/j.seizure.2018.01.011. Epub 2018 Jan 31.
6
Patient-Centered Management of Brain Tumor-Related Epilepsy.脑肿瘤相关癫痫的以患者为中心的管理。
Curr Neurol Neurosci Rep. 2024 Sep;24(9):413-422. doi: 10.1007/s11910-024-01360-z. Epub 2024 Jul 17.
7
Awake craniotomies for epileptic gliomas: intraoperative and postoperative seizure control and prognostic factors.清醒开颅术治疗癫痫性脑胶质瘤：术中及术后癫痫控制和预后因素。
J Neurooncol. 2019 May;142(3):577-586. doi: 10.1007/s11060-019-03131-0. Epub 2019 Feb 25.
8
Brain tumor-related epilepsy management: A Society for Neuro-oncology (SNO) consensus review on current management.脑肿瘤相关癫痫的管理：神经肿瘤学会（SNO）对当前管理的共识综述。
Neuro Oncol. 2024 Jan 5;26(1):7-24. doi: 10.1093/neuonc/noad154.
9
Correlation of Clinicopathological Factors with Brain Tumor-Related Epilepsy in Glioma.脑肿瘤相关性癫痫与胶质瘤临床病理因素的相关性。
Dis Markers. 2022 Sep 30;2022:4918294. doi: 10.1155/2022/4918294. eCollection 2022.
10
Perampanel in patients with brain tumor-related epilepsy in real-life clinical practice: a retrospective analysis.真实临床实践中脑肿瘤相关性癫痫患者应用吡仑帕奈：回顾性分析。
Int J Neurosci. 2019 Jun;129(6):593-597. doi: 10.1080/00207454.2018.1555160. Epub 2018 Dec 26.
引用本文的文献
1
Research progress in glioma-related epilepsy (Review).胶质瘤相关性癫痫的研究进展（综述）
Biomed Rep. 2025 Aug 19;23(4):167. doi: 10.3892/br.2025.2045. eCollection 2025 Oct.
2
A New Predictor Score for Postoperative Seizures in Brain Tumor Patients Without a Seizure History (BRAINNN Score).一种用于无癫痫病史的脑肿瘤患者术后癫痫发作的新预测评分（BRAINNN评分）。
Cureus. 2025 May 19;17(5):e84424. doi: 10.7759/cureus.84424. eCollection 2025 May.
3
Significance of miR-1290 in glioblastoma patients with epilepsy.miR-1290在胶质母细胞瘤伴癫痫患者中的意义。
Sci Rep. 2025 Apr 22;15(1):13911. doi: 10.1038/s41598-025-97855-x.
4
Use of psychotropic medications among glioma patients in Denmark, Norway, Sweden, and Wales.丹麦、挪威、瑞典和威尔士神经胶质瘤患者中精神药物的使用情况。
J Neurooncol. 2025 Jun;173(2):383-395. doi: 10.1007/s11060-025-04996-0. Epub 2025 Apr 10.
5
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.
6
Editorial: Seizures in brain tumors.社论：脑肿瘤中的癫痫发作
Front Surg. 2024 Oct 29;11:1504572. doi: 10.3389/fsurg.2024.1504572. eCollection 2024.
7
Plasma alpha B crystallin as potential biomarker for predicting pre-operative seizures in glioma.血浆 αB 晶体蛋白作为预测脑胶质瘤术前癫痫的潜在生物标志物。
BMC Neurol. 2024 Jul 6;24(1):237. doi: 10.1186/s12883-024-03740-x.
本文引用的文献
1
Brain tumor related epilepsy: pathophysiological approaches and rational management of antiseizure medication.脑肿瘤相关性癫痫：抗癫痫药物的病理生理学方法及合理管理
Neurol Res Pract. 2022 Sep 5;4(1):45. doi: 10.1186/s42466-022-00205-9.
2
IDH1/2 wildtype gliomas grade 2 and 3 with molecular glioblastoma-like profile have a distinct course of epilepsy compared to IDH1/2 wildtype glioblastomas.IDH1/2 野生型 2 级和 3 级胶质瘤伴分子胶质母细胞瘤样特征的癫痫发作过程与 IDH1/2 野生型胶质母细胞瘤明显不同。
Neuro Oncol. 2023 Apr 6;25(4):701-709. doi: 10.1093/neuonc/noac197.
3
Management of epilepsy in brain tumor patients.脑肿瘤患者的癫痫管理。
Curr Opin Oncol. 2022 Nov 1;34(6):685-690. doi: 10.1097/CCO.0000000000000876. Epub 2022 Jul 16.
4
Understanding epilepsy in IDH-mutated gliomas: towards a targeted therapy.了解异柠檬酸脱氢酶（IDH）突变型胶质瘤中的癫痫：迈向靶向治疗
Neuro Oncol. 2022 Sep 1;24(9):1436-1437. doi: 10.1093/neuonc/noac122.
5
The Concept of «Peritumoral Zone» in Diffuse Low-Grade Gliomas: Oncological and Functional Implications for a Connectome-Guided Therapeutic Attitude.弥漫性低级别胶质瘤中“瘤周区域”的概念：对基于脑连接组引导治疗态度的肿瘤学及功能影响
Brain Sci. 2022 Apr 15;12(4):504. doi: 10.3390/brainsci12040504.
6
Lacosamide in monotherapy in BTRE (brain tumor-related epilepsy): results from an Italian multicenter retrospective study.拉考沙胺单药治疗 BTRE（脑肿瘤相关性癫痫）：一项意大利多中心回顾性研究的结果。
J Neurooncol. 2022 May;157(3):551-559. doi: 10.1007/s11060-022-03998-6. Epub 2022 Apr 9.
7
Prescription preferences of antiepileptic drugs in brain tumor patients: An international survey among EANO members.脑肿瘤患者抗癫痫药物的处方偏好：一项针对欧洲神经肿瘤协会（EANO）成员的国际调查
Neurooncol Pract. 2021 Oct 21;9(2):105-113. doi: 10.1093/nop/npab059. eCollection 2022 Apr.
8
Nonepileptic attacks in patients with brain tumor-related epilepsy.脑肿瘤相关性癫痫患者中的非癫痫发作。
Epilepsy Behav. 2022 Apr;129:108656. doi: 10.1016/j.yebeh.2022.108656. Epub 2022 Mar 16.
9
Classification of adult-type diffuse gliomas: Impact of the World Health Organization 2021 update.成人型弥漫性胶质瘤分类：世界卫生组织 2021 年更新的影响。
Brain Pathol. 2022 Jul;32(4):e13062. doi: 10.1111/bpa.13062. Epub 2022 Mar 14.
10
The IDH1 inhibitor ivosidenib improved seizures in a patient with drug-resistant epilepsy from IDH1 mutant oligodendroglioma.异柠檬酸脱氢酶1（IDH1）抑制剂艾伏尼布改善了一名患有IDH1突变型少突胶质细胞瘤所致耐药性癫痫患者的癫痫发作情况。
Epilepsy Behav Rep. 2022 Jan 29;18:100526. doi: 10.1016/j.ebr.2022.100526. eCollection 2022.
Zotero 插件