Levetiracetam Prophylaxis Therapy for Brain Tumor-Related Epilepsy (BTRE) Is Associated with a Higher Psychiatric Burden
Abstract number :
2.232
Submission category :
7. Anti-seizure Medications / 7D. Drug Side Effects
Year :
2021
Submission ID :
1826607
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:55 AM
Authors :
Stefano Consoli, MD - "G. D'Annunzio" University of Chieti-Pescara; Fedele Dono - "G. D'Annunzio" University of Chieti-Pescara; Giacomo Evangelista - "G. D'Annunzio" University of Chieti-Pescara; Annalisa Ricci - Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara; Francesca Anzellotti - Department of Neurology, "SS Annunziata" Hospital, Chieti; Marco Onofrj - Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy; Angelo Di Iorio - Department of Geriatrics, "G. D'Annunzio" University of Chieti-Pescara; Stefano Sensi - Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy; Laura Bonanni - Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara
Rationale: Brain tumor-related epilepsy (BTRE) is a condition characterized by the development of seizures in the context of an undergoing oncological background. Some authors indicate that the high incidence of BTRE justifies the use of prophylactic anti-seizure medications (ASM). Levetiracetam (LEV) is a third-generation ASM widely used in BTRE prophylaxis. The study aims to evaluate LEV neuropsychiatric side effects in BTRE prophylaxis.
Methods: Twenty-eight patients with brain tumors were consecutively selected from 2017 to 2019 and divided into two groups: patients with an ascertain diagnosis of BTRE on anti-seizure treatment (BTRE group) and patients with brain tumor who never had epilepsy and were on prophylactic anti-seizure treatment (PROPHYLAXIS group). Demographics, clinical, neurophysiological, and neuroradiological data of patients of the two groups were assessed. BTRE features, including seizure type, seizure frequency, and anti-seizure therapy, were also evaluated. Neuropsychiatric side effects (SE) of anti-seizure treatment were monitored using the Neuropsychiatric Inventory Questionnaire (NPI-Q) at the baseline visit and 6-month and 12-month follow-up.
Results: 18 patients in the BTRE group and 15 patients in the PROPHYLAXIS group were included. Compared to the BTRE group, the PROPHYLAXIS group showed higher incidence and severity of neuropsychiatric symptoms as assessed by NPI-Q score. According Linear Mixed Models, a multiplicative effect for the interaction between group-treatment for time (p-value=0.02) was observed. For the caregiver distress score (CDS) only a Time-effect was observed (p=0.001) whereas no additive or multiplicative effect was found. Seizure freedom was observed in 15/17 (88%) patients of the BTRE group.
Conclusions: Prophylactic anti-seizure treatment with LEV is associated with increased neuropsychiatric adverse effects. These results stress the importance of accurate epileptological evaluations in patients with brain tumor to carefully select the ones who would benefit most from anti-seizure therapy.
Funding: Please list any funding that was received in support of this abstract.: No funding was received for this study.
Anti-seizure Medications