Abstracts

RATIONALE: Seizures are common in brain tumor patients, and traditional anti-epileptic drugs (AEDs) pose problems, including interactions with chemotherapeutic agents and cognitive side effects. Levetiracetam (LEV) is generally well tolerated and has few drug interactions, and its usefulness in this poupulation is studied.
METHODS: We reviewed all patients with brain tumors seen in our department between 1/2000-3/2002. 49 patients had taken LEV; 41 took it for at least 6 months, while 2 died in [lt]6 mo., 2 were lost to follow-up, and 4 started too recently. Of 41 analyzed patients (18M, 23F; age range 24-78), 18 had glioblastoma multiforme, 5 anaplastic astrocytoma, 8 mixed glioma, 6 oligodendroglioma, 2 meningioma, and 2 metastases. 23/41 (57%) had seizures at presentation, 32 (78%) had seizures after surgery, and 2 (4%) had no seizures.
RESULTS: LEV was initiated because of: 1) chemotherapy protocol (no enzyme-inducing drugs allowed), 8/41; 2) neutropenia on prior AEDs, 8/41; 3) sedation and fatigue on prior AED, 9/41; 4) poor seizure control, 13/41; 5) seizure prophylaxis, 2/14. 16 patients were on LEV monotherapy and 25 on polytherapy. LEV dose was 1000-3000 mg/d.
Adverse effects included: mood disturbances, 5/41 (requiring discontinuation in 1); fatigue or sedation, 2/41; other, 1. 41/42 have continued the drug for 6-18 mo. 21/41 had no seizures on LEV, 11/41 patients had moderate seizure reduction, and 2/41 had no improvement. 2 patients taking LEV for prophylaxis had no seizures.
CONCLUSIONS: LEV appears to be effective and well tolerated in patients with brain tumors.