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Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios

Epilepsy represents a challenge in the management of patients with brain tumors. Epileptic seizures are one of the most frequent comorbidities in neuro-oncology and may be the debut symptom of a brain tumor or a complication during its evolution. Epileptogenic mechanisms of brain tumors are not yet...

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Autores principales: Sánchez-Villalobos, José Manuel, Aledo-Serrano, Ángel, Villegas-Martínez, Irene, Shaikh, Mohd Farooq, Alcaraz, Miguel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583251/
https://www.ncbi.nlm.nih.gov/pubmed/36278161
http://dx.doi.org/10.3389/fphar.2022.991244
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author Sánchez-Villalobos, José Manuel
Aledo-Serrano, Ángel
Villegas-Martínez, Irene
Shaikh, Mohd Farooq
Alcaraz, Miguel
author_facet Sánchez-Villalobos, José Manuel
Aledo-Serrano, Ángel
Villegas-Martínez, Irene
Shaikh, Mohd Farooq
Alcaraz, Miguel
author_sort Sánchez-Villalobos, José Manuel
collection PubMed
description Epilepsy represents a challenge in the management of patients with brain tumors. Epileptic seizures are one of the most frequent comorbidities in neuro-oncology and may be the debut symptom of a brain tumor or a complication during its evolution. Epileptogenic mechanisms of brain tumors are not yet fully elucidated, although new factors related to the underlying pathophysiological process with possible treatment implications have been described. In recent years, the development of new anti-seizure medications (ASM), with better pharmacokinetic profiles and fewer side effects, has become a paradigm shift in many clinical scenarios in neuro-oncology, being able, for instance, to adapt epilepsy treatment to specific features of each patient. This is crucial in several situations, such as patients with cognitive/psychiatric comorbidity, pregnancy, or advanced age, among others. In this narrative review, we provide a rationale for decision-making in ASM choice for neuro-oncologic patients, highlighting the strengths and weaknesses of each drug. In addition, according to current literature evidence, we try to answer some of the most frequent questions that arise in daily clinical practice in patients with epilepsy related to brain tumors, such as, which patients are the best candidates for ASM and when to start it, what is the best treatment option for each patient, and what are the major pitfalls to be aware of during follow-up.
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spelling pubmed-95832512022-10-21 Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios Sánchez-Villalobos, José Manuel Aledo-Serrano, Ángel Villegas-Martínez, Irene Shaikh, Mohd Farooq Alcaraz, Miguel Front Pharmacol Pharmacology Epilepsy represents a challenge in the management of patients with brain tumors. Epileptic seizures are one of the most frequent comorbidities in neuro-oncology and may be the debut symptom of a brain tumor or a complication during its evolution. Epileptogenic mechanisms of brain tumors are not yet fully elucidated, although new factors related to the underlying pathophysiological process with possible treatment implications have been described. In recent years, the development of new anti-seizure medications (ASM), with better pharmacokinetic profiles and fewer side effects, has become a paradigm shift in many clinical scenarios in neuro-oncology, being able, for instance, to adapt epilepsy treatment to specific features of each patient. This is crucial in several situations, such as patients with cognitive/psychiatric comorbidity, pregnancy, or advanced age, among others. In this narrative review, we provide a rationale for decision-making in ASM choice for neuro-oncologic patients, highlighting the strengths and weaknesses of each drug. In addition, according to current literature evidence, we try to answer some of the most frequent questions that arise in daily clinical practice in patients with epilepsy related to brain tumors, such as, which patients are the best candidates for ASM and when to start it, what is the best treatment option for each patient, and what are the major pitfalls to be aware of during follow-up. Frontiers Media S.A. 2022-10-06 /pmc/articles/PMC9583251/ /pubmed/36278161 http://dx.doi.org/10.3389/fphar.2022.991244 Text en Copyright © 2022 Sánchez-Villalobos, Aledo-Serrano, Villegas-Martínez, Shaikh and Alcaraz. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Sánchez-Villalobos, José Manuel
Aledo-Serrano, Ángel
Villegas-Martínez, Irene
Shaikh, Mohd Farooq
Alcaraz, Miguel
Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios
title Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios
title_full Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios
title_fullStr Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios
title_full_unstemmed Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios
title_short Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios
title_sort epilepsy treatment in neuro-oncology: a rationale for drug choice in common clinical scenarios
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583251/
https://www.ncbi.nlm.nih.gov/pubmed/36278161
http://dx.doi.org/10.3389/fphar.2022.991244
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