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Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients

BACKGROUND: The efficacy of perioperative prophylactic antiepileptic drug therapy in “seizure-naïve” patients with brain tumor, including glioblastoma (GBM), remains controversial. This study investigated whether perampanel (PER) is effective and safe for preventing perioperative onset of epileptic...

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Autores principales: Kusakabe, Kosuke, Inoue, Akihiro, Watanabe, Hideaki, Nakamura, Yawara, Nishikawa, Masahiro, Ohtsuka, Yoshihiro, Ogura, Masahiro, Shigekawa, Seiji, Taniwaki, Mashio, Kitazawa, Riko, Kunieda, Takeharu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481804/
https://www.ncbi.nlm.nih.gov/pubmed/37680915
http://dx.doi.org/10.25259/SNI_495_2023
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author Kusakabe, Kosuke
Inoue, Akihiro
Watanabe, Hideaki
Nakamura, Yawara
Nishikawa, Masahiro
Ohtsuka, Yoshihiro
Ogura, Masahiro
Shigekawa, Seiji
Taniwaki, Mashio
Kitazawa, Riko
Kunieda, Takeharu
author_facet Kusakabe, Kosuke
Inoue, Akihiro
Watanabe, Hideaki
Nakamura, Yawara
Nishikawa, Masahiro
Ohtsuka, Yoshihiro
Ogura, Masahiro
Shigekawa, Seiji
Taniwaki, Mashio
Kitazawa, Riko
Kunieda, Takeharu
author_sort Kusakabe, Kosuke
collection PubMed
description BACKGROUND: The efficacy of perioperative prophylactic antiepileptic drug therapy in “seizure-naïve” patients with brain tumor, including glioblastoma (GBM), remains controversial. This study investigated whether perampanel (PER) is effective and safe for preventing perioperative onset of epileptic seizures, so-called early seizure, in patients with brain tumors. METHODS: Forty-five patients underwent tumor resection through craniotomy for a primary supratentorial brain tumor at Ehime University Hospital between April 2021 and July 2022. PER was administered from the 1(st) to the (6th) day after surgery for seizure prophylaxis. Occurrence of early seizure, hematological toxicities, and various side effects were recorded on postoperative days 7 and 14. In addition, the clinical course of these patients was compared with 42 brain tumor patients under the same treatment protocol who received levetiracetam (LEV) for seizure prophylaxis between April 2017 and October 2018. RESULTS: In 45 patients with brain tumor, including GBM, who received PER administration, no early seizures were identified within 7 days postoperatively. No adverse drug reactions such as hematological toxicity, liver or kidney dysfunction, or exanthematous drug eruption were observed in any cases. As side effects, somnolence was reported in 14 patients (31.1%), vertigo in 3 patients (6.7%), and headache in 3 patients (6.7%). Although somnolence and vertigo were difficult to assess in the case of intraparenchymal tumors, particularly GBM, these side effects were not identified in patients with extraparenchymal tumors such as meningiomas, epidermoid cysts, and pituitary adenomas. In addition, no significant differences were identified compared to patients who received LEV. CONCLUSION: The efficacy and safety of PER in preventing early seizures among patients with brain tumors were retrospectively evaluated. Perioperative administration of PER to patients with brain tumors may reduce the risk of early seizures without incurring serious side effects, showing no significant differences compared to patients who received LEV.
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spelling pubmed-104818042023-09-07 Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients Kusakabe, Kosuke Inoue, Akihiro Watanabe, Hideaki Nakamura, Yawara Nishikawa, Masahiro Ohtsuka, Yoshihiro Ogura, Masahiro Shigekawa, Seiji Taniwaki, Mashio Kitazawa, Riko Kunieda, Takeharu Surg Neurol Int Original Article BACKGROUND: The efficacy of perioperative prophylactic antiepileptic drug therapy in “seizure-naïve” patients with brain tumor, including glioblastoma (GBM), remains controversial. This study investigated whether perampanel (PER) is effective and safe for preventing perioperative onset of epileptic seizures, so-called early seizure, in patients with brain tumors. METHODS: Forty-five patients underwent tumor resection through craniotomy for a primary supratentorial brain tumor at Ehime University Hospital between April 2021 and July 2022. PER was administered from the 1(st) to the (6th) day after surgery for seizure prophylaxis. Occurrence of early seizure, hematological toxicities, and various side effects were recorded on postoperative days 7 and 14. In addition, the clinical course of these patients was compared with 42 brain tumor patients under the same treatment protocol who received levetiracetam (LEV) for seizure prophylaxis between April 2017 and October 2018. RESULTS: In 45 patients with brain tumor, including GBM, who received PER administration, no early seizures were identified within 7 days postoperatively. No adverse drug reactions such as hematological toxicity, liver or kidney dysfunction, or exanthematous drug eruption were observed in any cases. As side effects, somnolence was reported in 14 patients (31.1%), vertigo in 3 patients (6.7%), and headache in 3 patients (6.7%). Although somnolence and vertigo were difficult to assess in the case of intraparenchymal tumors, particularly GBM, these side effects were not identified in patients with extraparenchymal tumors such as meningiomas, epidermoid cysts, and pituitary adenomas. In addition, no significant differences were identified compared to patients who received LEV. CONCLUSION: The efficacy and safety of PER in preventing early seizures among patients with brain tumors were retrospectively evaluated. Perioperative administration of PER to patients with brain tumors may reduce the risk of early seizures without incurring serious side effects, showing no significant differences compared to patients who received LEV. Scientific Scholar 2023-08-11 /pmc/articles/PMC10481804/ /pubmed/37680915 http://dx.doi.org/10.25259/SNI_495_2023 Text en Copyright: © 2023 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kusakabe, Kosuke
Inoue, Akihiro
Watanabe, Hideaki
Nakamura, Yawara
Nishikawa, Masahiro
Ohtsuka, Yoshihiro
Ogura, Masahiro
Shigekawa, Seiji
Taniwaki, Mashio
Kitazawa, Riko
Kunieda, Takeharu
Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients
title Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients
title_full Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients
title_fullStr Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients
title_full_unstemmed Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients
title_short Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients
title_sort perioperative perampanel administration for early seizure prophylaxis in brain tumor patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481804/
https://www.ncbi.nlm.nih.gov/pubmed/37680915
http://dx.doi.org/10.25259/SNI_495_2023
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