Outcomes after discontinuation of antiepileptic drugs after surgery in patients with low grade brain tumors and meningiomas
Low grade tumors are associated with a high risk of seizures. Prolonged use of antiepileptic drugs (AEDs) is associated with morbidity. Determining which patients can safely discontinue AEDs perioperatively is difficult. We examined patients with low grade supratentorial brain tumors to determine ch...
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| Veröffentlicht in: | Journal of neuro-oncology 2012-05, Vol.107 (3), p.565-570 |
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| creator | Das, Rohit R. Artsy, Elinor Hurwitz, Shelley Wen, Patrick Y. Black, Peter Golby, Alexandra Dworetzky, Barbara Lee, Jong Woo |
| description | Low grade tumors are associated with a high risk of seizures. Prolonged use of antiepileptic drugs (AEDs) is associated with morbidity. Determining which patients can safely discontinue AEDs perioperatively is difficult. We examined patients with low grade supratentorial brain tumors to determine characteristics of patients who underwent AED withdrawal. A retrospective chart review was performed in patients who underwent resection between 1/1/2004 and 12/31/2005 at a single center. Data were collected regarding the use of postoperative AEDs, occurrence of postoperative seizures, and patient/tumor characteristics. We examined 169 patients with a median follow-up of 3.1 years. AEDs were withdrawn or never started in 111 patients; post-withdrawal seizures occurred in 11 (9.9%). The rate was similar between meningiomas and primary brain tumors. No independent risk factors for post-withdrawal seizures were found. Of 58 patients whose AEDs were not withdrawn, postoperative seizures occurred in 28 (48%). Predictors of AED continuation included existence of preoperative seizures, temporal tumor location, tumor recurrence, incomplete resection, and male sex. The decision to continue AEDs was predictive for postoperative seizures even after controlling for known risk factors. Although clinicians are able to identify patients at high risk for postoperative seizures, treatment with AEDs is ineffective in many patients. |
| doi_str_mv | 10.1007/s11060-011-0779-y |
| format | Article |
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Prolonged use of antiepileptic drugs (AEDs) is associated with morbidity. Determining which patients can safely discontinue AEDs perioperatively is difficult. We examined patients with low grade supratentorial brain tumors to determine characteristics of patients who underwent AED withdrawal. A retrospective chart review was performed in patients who underwent resection between 1/1/2004 and 12/31/2005 at a single center. Data were collected regarding the use of postoperative AEDs, occurrence of postoperative seizures, and patient/tumor characteristics. We examined 169 patients with a median follow-up of 3.1 years. AEDs were withdrawn or never started in 111 patients; post-withdrawal seizures occurred in 11 (9.9%). The rate was similar between meningiomas and primary brain tumors. No independent risk factors for post-withdrawal seizures were found. Of 58 patients whose AEDs were not withdrawn, postoperative seizures occurred in 28 (48%). Predictors of AED continuation included existence of preoperative seizures, temporal tumor location, tumor recurrence, incomplete resection, and male sex. The decision to continue AEDs was predictive for postoperative seizures even after controlling for known risk factors. Although clinicians are able to identify patients at high risk for postoperative seizures, treatment with AEDs is ineffective in many patients.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-011-0779-y</identifier><identifier>PMID: 22212850</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anticonvulsants - therapeutic use ; Antiepileptic agents ; Brain Neoplasms - complications ; Brain Neoplasms - surgery ; Brain tumors ; Clinical Study - Patient Study ; Data processing ; Female ; Humans ; Male ; Medicine ; Medicine & Public Health ; Meningeal Neoplasms - complications ; Meningeal Neoplasms - surgery ; meningioma ; Meningioma - complications ; Meningioma - surgery ; Middle Aged ; Morbidity ; Neurology ; Oncology ; Recurrence ; Retrospective Studies ; Risk factors ; Seizures ; Seizures - epidemiology ; Seizures - etiology ; Seizures - prevention & control ; Sex ; Surgery ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of neuro-oncology, 2012-05, Vol.107 (3), p.565-570</ispartof><rights>Springer Science+Business Media, LLC. 2011</rights><rights>Springer Science+Business Media, LLC. 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-e8532e58848f6e34c636d0c552a82aeb3116e386c4b9755fd9d9ce37c6dcd8ea3</citedby><cites>FETCH-LOGICAL-c403t-e8532e58848f6e34c636d0c552a82aeb3116e386c4b9755fd9d9ce37c6dcd8ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11060-011-0779-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11060-011-0779-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22212850$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Das, Rohit R.</creatorcontrib><creatorcontrib>Artsy, Elinor</creatorcontrib><creatorcontrib>Hurwitz, Shelley</creatorcontrib><creatorcontrib>Wen, Patrick Y.</creatorcontrib><creatorcontrib>Black, Peter</creatorcontrib><creatorcontrib>Golby, Alexandra</creatorcontrib><creatorcontrib>Dworetzky, Barbara</creatorcontrib><creatorcontrib>Lee, Jong Woo</creatorcontrib><title>Outcomes after discontinuation of antiepileptic drugs after surgery in patients with low grade brain tumors and meningiomas</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Low grade tumors are associated with a high risk of seizures. Prolonged use of antiepileptic drugs (AEDs) is associated with morbidity. Determining which patients can safely discontinue AEDs perioperatively is difficult. We examined patients with low grade supratentorial brain tumors to determine characteristics of patients who underwent AED withdrawal. A retrospective chart review was performed in patients who underwent resection between 1/1/2004 and 12/31/2005 at a single center. Data were collected regarding the use of postoperative AEDs, occurrence of postoperative seizures, and patient/tumor characteristics. We examined 169 patients with a median follow-up of 3.1 years. AEDs were withdrawn or never started in 111 patients; post-withdrawal seizures occurred in 11 (9.9%). The rate was similar between meningiomas and primary brain tumors. No independent risk factors for post-withdrawal seizures were found. Of 58 patients whose AEDs were not withdrawn, postoperative seizures occurred in 28 (48%). Predictors of AED continuation included existence of preoperative seizures, temporal tumor location, tumor recurrence, incomplete resection, and male sex. The decision to continue AEDs was predictive for postoperative seizures even after controlling for known risk factors. Although clinicians are able to identify patients at high risk for postoperative seizures, treatment with AEDs is ineffective in many patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticonvulsants - therapeutic use</subject><subject>Antiepileptic agents</subject><subject>Brain Neoplasms - complications</subject><subject>Brain Neoplasms - surgery</subject><subject>Brain tumors</subject><subject>Clinical Study - Patient Study</subject><subject>Data processing</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meningeal Neoplasms - complications</subject><subject>Meningeal Neoplasms - surgery</subject><subject>meningioma</subject><subject>Meningioma - complications</subject><subject>Meningioma - surgery</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Neurology</subject><subject>Oncology</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Seizures</subject><subject>Seizures - epidemiology</subject><subject>Seizures - etiology</subject><subject>Seizures - prevention & control</subject><subject>Sex</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kctrFTEUh4NY7LX6B7iR4EY30-YxecxSSn1AoRsL7obc5Mw1ZSYZ86Bc_OfN9bYKgq5Ccr7zJSc_hF5Rck4JUReZUiJJRyjtiFJDt3-CNlQo3imu-FO0IVSqTgz911P0POc7QkivOH2GThljlGlBNujHTS02LpCxmQok7Hy2MRQfqik-BhwnbNoWVj_DWrzFLtXdI5xr2kHaYx_w2nAIJeN7X77hOd7jXTIO8DaZVi11ial1BYcXCD7sfFxMfoFOJjNnePmwnqHbD1dfLj911zcfP1--v-5sT3jpQAvOQGjd60kC763k0hErBDOaGdhyStuxlrbfDkqIyQ1usMCVlc46DYafobdH75ri9wq5jEubEubZBIg1j8PANKeSsUa--y_Zfr09ox_kAX3zF3oXawptjl8-yYmgDaJHyKaYc4JpXJNfTNo300GmxmOEY4twPEQ47lvP6wdx3S7gfnc8ZtYAdgRyK4UWwJ-b_239CTZNqUk</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Das, Rohit R.</creator><creator>Artsy, Elinor</creator><creator>Hurwitz, Shelley</creator><creator>Wen, Patrick Y.</creator><creator>Black, Peter</creator><creator>Golby, Alexandra</creator><creator>Dworetzky, Barbara</creator><creator>Lee, Jong Woo</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>Outcomes after discontinuation of antiepileptic drugs after surgery in patients with low grade brain tumors and meningiomas</title><author>Das, Rohit R. ; 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Prolonged use of antiepileptic drugs (AEDs) is associated with morbidity. Determining which patients can safely discontinue AEDs perioperatively is difficult. We examined patients with low grade supratentorial brain tumors to determine characteristics of patients who underwent AED withdrawal. A retrospective chart review was performed in patients who underwent resection between 1/1/2004 and 12/31/2005 at a single center. Data were collected regarding the use of postoperative AEDs, occurrence of postoperative seizures, and patient/tumor characteristics. We examined 169 patients with a median follow-up of 3.1 years. AEDs were withdrawn or never started in 111 patients; post-withdrawal seizures occurred in 11 (9.9%). The rate was similar between meningiomas and primary brain tumors. No independent risk factors for post-withdrawal seizures were found. Of 58 patients whose AEDs were not withdrawn, postoperative seizures occurred in 28 (48%). Predictors of AED continuation included existence of preoperative seizures, temporal tumor location, tumor recurrence, incomplete resection, and male sex. The decision to continue AEDs was predictive for postoperative seizures even after controlling for known risk factors. Although clinicians are able to identify patients at high risk for postoperative seizures, treatment with AEDs is ineffective in many patients.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>22212850</pmid><doi>10.1007/s11060-011-0779-y</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Anticonvulsants - therapeutic use Antiepileptic agents Brain Neoplasms - complications Brain Neoplasms - surgery Brain tumors Clinical Study - Patient Study Data processing Female Humans Male Medicine Medicine & Public Health Meningeal Neoplasms - complications Meningeal Neoplasms - surgery meningioma Meningioma - complications Meningioma - surgery Middle Aged Morbidity Neurology Oncology Recurrence Retrospective Studies Risk factors Seizures Seizures - epidemiology Seizures - etiology Seizures - prevention & control Sex Surgery Treatment Outcome Young Adult |
| title | Outcomes after discontinuation of antiepileptic drugs after surgery in patients with low grade brain tumors and meningiomas |
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