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Brain Tumours and Prophylactic Antiepileptic Drug Prescribing Patterns by Neurosurgeons Practising in Australasia

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DOI: 10.4236/nm.2015.61003    2,092 Downloads   2,482 Views   Citations

ABSTRACT

Prescribing patterns amongst practising Australasian neurosurgeons regarding the use of prophylactic antiepileptic drugs (AEDs) in patients with newly diagnosed intrinsic brain tumours are not well established. This study aimed to determine the rate of prophylactic AED prescribing in this clinical context and to determine if there were some particular factors that influenced prescribers in their decision. A survey was conducted, and of the 91 respondents, 23 (25.3%) prescribed prophylactic AEDs. No neurosurgeons practising in New Zealand prescribed, whereas within Australian states/territories, prescribing was most common in Western Australia (3/4, 75.0%) and Queensland (8/18, 44.4%) and less common in the Australian Capital Territory (0/2, 0.0%) and South Australia (1/7, 14.3%). The most commonly prescribed first-line AED was phenytoin (n = 15, 68.2%) followed by levetiracetam (n = 5, 22.7%). The duration of prescription varied from 1 week to 6 months, with 6 weeks chosen by most prescribers (n = 7, 35%). Important factors that influence the decision to prescribe include tumour location and a history of previous seizure/s, whereas the presence of oedema or haemorrhage and patients’ age do not seem to be major influences amongst prescribers.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Tsimiklis, C. and Harding, M. (2015) Brain Tumours and Prophylactic Antiepileptic Drug Prescribing Patterns by Neurosurgeons Practising in Australasia. Neuroscience and Medicine, 6, 13-19. doi: 10.4236/nm.2015.61003.

References

[1] Lote, K., Stenwig, A.E., Skullerud, K. and Hirschberg, H. (1998) Prevalence and Prognostic Significance of Epilepsy in Patients with Gliomas. European Journal of Cancer, 34, 98-102.
[2] Oberndorfer, S., Schmal, T., Lahrmann, H., Urbanits, S., Lindner, K. and Grisold, W. (2002) The Frequency Of seizures in Patients with Primary Brain Tumours or Cerebral Metastases. An Evaluation from the Ludwig Boltzmann Institute of Neuro-Oncology and the Department of Neurology, Kaiser Franz Josef Hospital, Vienna. Wien Klin Wochenschr, 114, 911-916.
[3] Glantz, M.J., Cole, B.F., Forsyth, P.A., et al. (2000) Practice Parameter: Anticonvulsant Prophylaxis in Patients with Newly Diagnosed Brain Tumors. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 54, 1886-1893.
http://dx.doi.org/10.1212/WNL.54.10.1886
[4] Sirven, J.I., Wingerchuk, D.M., Drazkowski, J.F., Lyons, M.K. and Zimmerman, R.S. (2004) Seizure Prophylaxis in Patients with Brain Tumors: A Meta-Analysis. Mayo Clinic Proceedings, 79, 1489-94.
http://dx.doi.org/10.4065/79.12.1489
[5] Wu, A.S., Trinh, V.T., Suki, D., et al. (2013) A Prospective Randomized Trial of Perioperative Seizure Prophylaxis in Patients with Intraparenchymal Brain Tumors. Journal of Neurosurgery, 118, 873-883.
http://dx.doi.org/10.3171/2012.12.JNS111970
[6] Klein, M., Engelberts, N.H., van der Ploeg, H.M., et al. (2003) Epilepsy in Low-Grade Gliomas: The Impact on Cognitive Function and Quality of Life. Annals of Neurology, 54, 514-520.
http://dx.doi.org/10.1002/ana.10712
[7] Khafaga, Y.M., Jamshed, A., Allam, A.A., et al. (1999) Stevens-Johnson Syndrome in Patients on Phenytoin and Cranial Radiotherapy. Acta Oncologica, 38, 111-116.
http://dx.doi.org/10.1080/028418699431898
[8] Australian Government Department of Health [Internet] The Pharmaceutical Benefits Scheme (PBS). Australia.
http://www.pbs.gov.au/medicine/item/8654L-8655M-8656N-9169N.
[9] Fuller, K.L., Wang, Y.Y., Cook, M.J., Murphy, M.A. and D’Souza, W.J. (2013) Tolerability, Safety, and Side Effects of Levetiracetam versus Phenytoin in Intravenous and Total Prophylactic Regimen among Craniotomy Patients: A Prospective Randomized Study. Epilepsia, 54, 45-57.
http://dx.doi.org/10.1111/j.1528-1167.2012.03563.x
[10] Van Breemen, M.S., Wilms, E.B. and Vecht, C.J. (2007) Epilepsy in Patients with Brain Tumours: Epidemiology, Mechanisms, and Management. The Lancet Neurology, 6, 421-30.
http://dx.doi.org/10.1016/S1474-4422(07)70103-5
[11] Page, M. (2007) Psychotropic Drugs and Dentistry. Australian Prescriber, 30, 98-101.
[12] Guthrie, G.D. and Eljamel, S. (2013) Impact of Particular Antiepileptic Drugs on the Survival of Patients with Glioblastoma Multiforme. Journal of Neurosurgery, 118, 859-65.
http://dx.doi.org/10.3171/2012.10.JNS12169

  
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