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Antiepileptic drugs in treating structural epilepsy of patients with metastatic brain cancer: a combination approach

https://doi.org/10.17749/2077-8333/epi.par.con.2022.065

Abstract

Objective: to study the effect of perampanel on the dynamics of epileptic seizures and anxiety in patients with brain metastases and epileptic seizures during chemotherapy (CT), radiotherapy (RT), and radiochemotherapy  (RCT).

Material and methods. The prospective clinical study included 48 patients with lung cancer and 39 women with breast cancer who underwent removal of primary focus.  After CT, RT or RCT epileptic seizures  were registered.  Brain metastases were revealed at brain magnetic  resonance imaging data. All patients underwent general and neurological examination as well as electroencephalography. The level of anxiety was assessed by the Beck Anxiety Inventory. Рatients were prescribed perampanel by the concilium decision.

Results. It was shown that administered perampanel was effective in any primary tumor location. The quantity of repeated epileptic seizures in all patients with lung and breast metastatic cancer was significantly decreased on Day 6–7 after adding perampanel to either earlier received antiepileptic drugs or as a monotherapy (p=0.0431).  In the follow-up period with the median survival rate of 8–13 months, the frequency of epileptic seizures was decreased and then remained stable. Perampanel as mono- or multitherapy positively influenced on controlling anxiety disorders in 25–75% patients with brain metastases.The level of anxiety was decreased due to lowered epileptic activity.

Conclusion. Based on the study results, we could recommend administration of perampanel for the treatment of metastatic brain cancers in patients with diverse primary tumors as well as both partial and generalized epileptic seizures while applying CT, RT, RCT or palliative care.

About the Authors

A. S. Shershever
Sverdlovsk Regional Oncological Dispensary
Russian Federation

Alexander S. Shershever – Dr. Med. Sc., Professor, Deputy Chief Physician for Scientific Work, Sverdlovsk Regional Oncological Dispensary.

29 Sobolev Str., Ekaterinburg 620036.

RSCI SPIN-code: 2624-1048



S. A. Lavrova
Sverdlovsk Regional Oncological Dispensary
Russian Federation

Svetlana A. Lavrova – MD, PhD, Functional Diagnostician, Sverdlovsk Regional Oncological Dispensary.

29 Sobolev Str., Ekaterinburg 620036.



D. L. Bentsion
Sverdlovsk Regional Oncological Dispensary
Russian Federation

Dmitry L. Bentsion – MD, PhD, Oncologist, Radiologist, Sverdlovsk Regional Oncological Dispensary.

29 Sobolev Str., Ekaterinburg 620036.



V. V. Makhnev
Sverdlovsk Regional Oncological Dispensary
Russian Federation

Vladislav V. Makhnev – MD, PhD, Radiotherapist, Sverdlovsk Regional Oncological Dispensary.

29 Sobolev Str., Ekaterinburg 620036.



A. S. Kulakova
Sverdlovsk Regional Oncological Dispensary
Russian Federation

Anastasia S. Kulakova – Radiotherapist,  Head of the First Radiology  Department, Sverdlovsk Regional Oncological Dispensary.

29 Sobolev Str., Ekaterinburg 620036.



M. A. Zafirova
Sverdlovsk Regional Oncological Dispensary
Russian Federation

Marina A. Zafirova – Head of Chemotherapeutic Service, Sverdlovsk Regional Oncological Dispensary.

29 Sobolev Str., Ekaterinburg 620036.



E. V. Sorokova
City Clinical Hospital No. 40
Russian Federation

Elena V. Sorokova – Neurologist,  Epileptologist, City Clinical Hospital No. 40.

189 Volgogradskaya Str., Ekaterinburg 620102.



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Review

For citations:


Shershever A.S., Lavrova S.A., Bentsion D.L., Makhnev V.V., Kulakova A.S., Zafirova M.A., Sorokova E.V. Antiepileptic drugs in treating structural epilepsy of patients with metastatic brain cancer: a combination approach. Epilepsy and paroxysmal conditions. 2022;14(1):15-27. (In Russ.) https://doi.org/10.17749/2077-8333/epi.par.con.2022.065

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ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)